Canadian evidence‐based guidelines on spinal procedures for chronic pain

Summary Introduction Interventional procedures are commonly used to diagnose and treat chronic pain of spinal origin but guidance on: their indications; frequency; technical conduct; requirements for image guidance; outcome measurement; and management of complications is lacking. These guidelines were developed by a Canadian group of clinicians, researchers, patient partners and representatives from provincial healthcare regulatory and funding bodies. Methods Reviews of published literature were undertaken for commonly performed spinal procedures for pain, and the evidence was synthesised qualitatively. Evidence‐based recommendations for each procedure were graded on a scale from A (strongest level) to D (not recommended), or as insufficient (I), using US Preventive Services Task Force criteria with the level of certainty rated as high, medium or low. All consensus recommendations required at least 75% agreement among the guideline panel. Good clinical practice statements were also developed. Results We provide 15 key recommendations. The guidelines provide clinical practice recommendations and good clinical practice statements for procedures targeting chronic pain originating from the cervical, lumbar spine and sacroiliac joints. Clinical indications, evidence for efficacy and suggested frequency for repeated procedures have also been proposed. Discussion These guidelines provide evidence‐based recommendations and good clinical practice statements for performing diagnostic and therapeutic spinal interventions for chronic pain.

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Publication Details

Journal
Anaesthesia
Published
2026-10-18
DOI
https://doi.org/10.1111/anae.70440
Primary Topic
Pain Management and Treatment
Type
article
Field-Weighted Citation Impact
0.00
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article

Canadian evidence‐based guidelines on spinal procedures for chronic pain

Paul Etheridge, Ian Gilron, Martina Rekatsina, Magali Robert et al.
Anaesthesia
Pain Management and Treatment
article

Canadian evidence‐based guidelines on spinal procedures for chronic pain

Paul Etheridge, Ian Gilron, Martina Rekatsina, Magali Robert, Pam Squire, Christopher Mares, John X. Pereira, Mohan Radhakrishna, James S. Khan, Hance A. Clarke, Roderick J. Finlayson, Anuj Bhatia, Sebastian Charles Mafeld, Shawn Marshall, Ian G. Beauprie, Norman Buckley, Elad Dana, Yasmine Hoydonckx, Harsha Shanthanna, Andrea D Furlan, Philip Peng, DANIELLE C.L. ALVARES, Abeer Alomari, Howard Meng, Tarvit Worravitudomsuk, Eldon Loh, Robert Tanguay
article en

Abstract

Summary Introduction Interventional procedures are commonly used to diagnose and treat chronic pain of spinal origin but guidance on: their indications; frequency; technical conduct; requirements for image guidance; outcome measurement; and management of complications is lacking. These guidelines were developed by a Canadian group of clinicians, researchers, patient partners and representatives from provincial healthcare regulatory and funding bodies. Methods Reviews of published literature were undertaken for commonly performed spinal procedures for pain, and the evidence was synthesised qualitatively. Evidence‐based recommendations for each procedure were graded on a scale from A (strongest level) to D (not recommended), or as insufficient (I), using US Preventive Services Task Force criteria with the level of certainty rated as high, medium or low. All consensus recommendations required at least 75% agreement among the guideline panel. Good clinical practice statements were also developed. Results We provide 15 key recommendations. The guidelines provide clinical practice recommendations and good clinical practice statements for procedures targeting chronic pain originating from the cervical, lumbar spine and sacroiliac joints. Clinical indications, evidence for efficacy and suggested frequency for repeated procedures have also been proposed. Discussion These guidelines provide evidence‐based recommendations and good clinical practice statements for performing diagnostic and therapeutic spinal interventions for chronic pain.

Anaesthesia
Western University (CA), Mount Sinai Hospital (CA), Dalhousie University (CA), Sunnybrook Health Science Centre (CA), University Health Network (CA), University of British Columbia (CA), University of Ottawa (CA), Tel Aviv University (IL), University of Calgary (CA), University of Toronto (CA), National and Kapodistrian University of Athens (GR), Toronto Rehabilitation Institute (CA), Ottawa Hospital (CA), Kingston General Hospital (CA), Kelowna General Hospital (CA), McGill University Health Centre (CA), Meir Medical Center (IL), King Chulalongkorn Memorial Hospital (TH), Cleveland Clinic Lerner College of Medicine (US), Aretaeio Hospital (GR), Public Health Ontario (CA), Centre Hospitalier de l’Université de Montréal (CA), McMaster University (CA)
Openalex Percentile: Top 8%
Pain Management and Treatment
DOIOpen Access PDFOpenAlex
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