The American Society of Pain and Neuroscience (ASPN) Evidence-Based Clinical Guideline of Interventional Treatments for Low Back Pain


Dawood Sayed, Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, KS, USA.
Jay Grider, University of Kentucky, Lexington, KY, USA.
Natalie Strand, Interventional Pain Management, Mayo Clinic, Scottsdale, AZ, USA.
Jonathan M. Hagedorn, iSpine Pain Physicians, Maple Grove, MN, USA.
Steven Falowski, Functional Neurosurgery, Neurosurgical Associates of Lancaster, Lancaster, PA, USA.
Christopher M. Lam, Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, KS, USA.
Vinicius Tieppo Francio, Department of Rehabilitation Medicine, University of Kansas Medical Center, Kansas City, KS, USA.
Douglas P. Beall, Comprehensive Specialty Care, Edmond, OK, USA.
Nestor D. Tomycz, AHN Neurosurgery, Allegheny General Hospital, Pittsburgh, PA, USA.
Justin R. Davanzo, AHN Neurosurgery, Forbes Hospital, Monroeville, PA, USA.
Rohit Aiyer, Interventional Pain Management and Pain Psychiatry, Henry Ford Health System, Detroit, MI, USA.
David W. Lee, Physical Medicine & Rehabilitation and Pain Medicine, Fullerton Orthopedic Surgery Medical Group, Fullerton, CA, USA.
Hemant Kalia, Rochester Regional HealthFollow
Soun Sheen, Department of Physical Medicine & Rehabilitation, University of Rochester, Rochester, NY, USA.
Mark N. Malinowski, Adena Spine Center, Adena Health System, Chillicothe, OH, USA.
Michael Verdolin, Anesthesiology and Pain Medicine, Pain Consultants of San Diego, San Diego, CA, USA.
Shashank Vodapally, Physical Medicine and Rehabilitation, Michigan State University, East Lansing, MI, USA.
Alexios Carayannopoulos, Department of Physical Medicine and Rehabilitation, Rhode Island Hospital, Newport Hospital, Lifespan Physician Group, Providence, RI, USA.
Sameer Jain, Interventional Pain Management, Pain Treatment Centers of America, Little Rock, AR, USA.
Nomen Azeem, Department of Neurology, University of South Florida, Tampa, FL, USA.
Reda Tolba, Pain Management, Cleveland Clinic, Abu Dhabi, United Arab Emirates.
George C. Chang Chien, Pain Management, Ventura County Medical Center, Ventura, CA, USA.
Priyanka Ghosh, Remedy Medical Group, San Francisco, CA, USA.
Anthony J. Mazzola, Mount Sinai Health System, New York City, NY, USA.
Kasra Amirdelfan, IPM Medical Group, Inc., Walnut Creek, CA, USA.
Krishnan Chakravarthy, Division of Pain Medicine, Department of Anesthesiology, University of California San Diego, San Diego, CA, USA.
Erika Petersen, Department of Neurosurgery, University of Arkansas for Medical Science, Little Rock, AR, USA.
Michael E. Schatman, Department of Anesthesiology, Perioperative Care, and Pain Medicine, NYU Grossman School of Medicine, New York, New York, USA.
Timothy Deer, The Spine and Nerve Center of the Virginias, Charleston, WV, USA.


Spine & Pain Medicine

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Journal of Pain Research


INTRODUCTION: Painful lumbar spinal disorders represent a leading cause of disability in the US and worldwide. Interventional treatments for lumbar disorders are an effective treatment for the pain and disability from low back pain. Although many established and emerging interventional procedures are currently available, there exists a need for a defined guideline for their appropriateness, effectiveness, and safety.

OBJECTIVE: The ASPN Back Guideline was developed to provide clinicians the most comprehensive review of interventional treatments for lower back disorders. Clinicians should utilize the ASPN Back Guideline to evaluate the quality of the literature, safety, and efficacy of interventional treatments for lower back disorders.

METHODS: The American Society of Pain and Neuroscience (ASPN) identified an educational need for a comprehensive clinical guideline to provide evidence-based recommendations. Experts from the fields of Anesthesiology, Physiatry, Neurology, Neurosurgery, Radiology, and Pain Psychology developed the ASPN Back Guideline. The world literature in English was searched using Medline, EMBASE, Cochrane CENTRAL, BioMed Central, Web of Science, Google Scholar, PubMed, Current Contents Connect, Scopus, and meeting abstracts to identify and compile the evidence (per section) for back-related pain. Search words were selected based upon the section represented. Identified peer-reviewed literature was critiqued using United States Preventive Services Task Force (USPSTF) criteria and consensus points are presented.

RESULTS: After a comprehensive review and analysis of the available evidence, the ASPN Back Guideline group was able to rate the literature and provide therapy grades to each of the most commonly available interventional treatments for low back pain.

CONCLUSION: The ASPN Back Guideline represents the first comprehensive analysis and grading of the existing and emerging interventional treatments available for low back pain. This will be a living document which will be periodically updated to the current standard of care based on the available evidence within peer-reviewed literature.

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