Peripheral Nerve Injury and Regeneration: Overview of the Sunderland Classification and What it Means for Pain Intervention

Learning Objectives: To provide an overview of peripheral nerve injury in Interventional Radiology

• Review the Sunderland Classification


• Provide an overview of how Interventional Radiology procedures cause nerve injury: blockade, thermal neurolysis, chemical neurolysis

Background: Interventional pain procedures frequently involve disruption of nociceptive pathways. This disruption can be achieved by causing temporary blockade of the nerve or through intentional damage to the nerve. The Sunderland classification is a system that categorizes the degree of nerve damage and correlates it with the expected regeneration time of the nerve. This is very important for pain interventionists to understand as this has implications for nerve recovery and possible return of symptoms.

Clinical Findings/Procedure Details: Exhibit will provide a review of mechanism of action, Sunderland Classification of injury, and expected regrowth time frame using the following techniques:

• Local Anesthetic and Steroids


• Phenol


• Ethanol


• Cryoablation


• Radiofrequency Ablation

Conclusion and/or Teaching Points: Intentional peripheral axonal injury is the basis for pain intervention and it is important to recognize the underlying mechanism of injury in the context of expected outcomes and eventual regeneration.