Interventional Pain Medicine最新文献

{"title":"Assessment of real-world, prospective outcomes in patients treated with lumbar radiofrequency ablation for chronic pain (RAPID)","authors":"David A. Provenzano ,&nbsp;Bradley Holt ,&nbsp;Michael Danko ,&nbsp;Joseph Atallah ,&nbsp;Maaz Iqbal ,&nbsp;Binit Shah ,&nbsp;Albert Singh ,&nbsp;Harsh Sachdeva ,&nbsp;Ella Ver Donck ,&nbsp;Erik Shaw ,&nbsp;Sherri Haas ,&nbsp;Rajat Sekhar ,&nbsp;Ann Pan ,&nbsp;Daniel S. Halperin ,&nbsp;Edward Goldberg","doi":"10.1016/j.inpm.2025.100576","DOIUrl":"10.1016/j.inpm.2025.100576","url":null,"abstract":"<div><h3>Background</h3><div>Lumbar facet joint syndrome (LFJS) is one of most common forms of chronic low back pain. Despite several decades of real-world use and a plethora of published studies, debate still exists regarding the effectiveness of Radiofrequency Ablation (RFA) as a therapy in LFJS-diagnosed patients.</div></div><div><h3>Objective</h3><div>Here, we sought to evaluate real-world clinical outcomes in RFA-treated patients with chronic lumbar facetogenic pain participating in one of the largest studies of its kind published to date.</div></div><div><h3>Methods</h3><div>The RAPID study (Clinicaltrials.gov identifier: NCT04673032) is an international, multicenter, prospective study of patients using a commercially-available radiofrequency ablation system for the treatment of chronic pain, provided per standard of care. Patients were assessed at pre-specified study follow-up visits (1-, 3-. 6-, 12-, and 24-months post-index procedure). Key clinical endpoint measures collected and evaluated include NRS (pain score), Oswestry Disability Index (functional disability, ODI), EQ-5D-5L (quality-of-life), and Patient Global Impression of Change (PGIC).</div></div><div><h3>Results</h3><div>To date, 193 patients have been enrolled in this lumbar facetogenic pain patient cohort. Evaluation of pain relief amongst patients assessed out to 24-months demonstrated a mean NRS score of 3.4 (baseline NRS: 6.6, p &lt; 0.0001). Consistent functional improvement out to 24-months was observed per an 8.6-point mean ODI score reduction (baseline ODI: 38.0, p &lt; 0.0001). Following RFA treatment at 1-month and out to 24-months, 77.0% and 79.0% of patients were observed to be treatment responders (i.e., ≥50% pain relief), respectively. Enhanced levels in measures of quality-of-life (EQ-5D-5L) and self-reported health-related change (PGIC) were also consistently noted.</div></div><div><h3>Conclusions</h3><div>Clinically meaningful and durable improvements in pain relief, functional disability, quality-of-life and treatment satisfaction were observed across all RAPID study follow-up visits. The results of the RAPID study provide for the potential clinical outcomes amongst selected patients with lumbar facetogenic pain within the real-world clinical setting.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100576"},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lumbar facet joint denervation targeting the medial branch in the sub-mammillary fossa: An anatomical optimization study","authors":"John Tran ,&nbsp;Aaron Conger ,&nbsp;Keaton Lightfoot ,&nbsp;Zachary L. McCormick ,&nbsp;Eldon Loh","doi":"10.1016/j.inpm.2025.100586","DOIUrl":"10.1016/j.inpm.2025.100586","url":null,"abstract":"<div><h3>Introduction</h3><div>Recent anatomical studies have identified the sub-mammillary fossa as a potential target site to extend the length and more reliably capture the medial branch during lumbar facet joint denervation. Although a clinical case series was published describing positive outcomes targeting the sub-mammillary fossa, the ideal location for radiofrequency cannula placement has not been assessed. Further anatomical investigation of this novel technique is warranted to refine fluoroscopic landmarks for optimal placement.</div></div><div><h3>Methods</h3><div>Twelve cannulae were placed under fluoroscopic guidance targeting the L3, L4, &amp; L5 medial branches in 2 embalmed cadaveric specimens. Dissection, digitization, and high-fidelity 3D modelling methodology was used to identify fluoroscopic landmarks. Lesion simulation was performed on 3D models to analyze nerve capture.</div></div><div><h3>Results</h3><div>In 5 of 12 placements (41.7 %), the medial branch capture rate was classified as “complete,” as the simulated lesion overlapped with the medial branch trunk or all of its distal branches. In 4 of 12 placements (33.3 %), the nerve capture rate was “partial” with at least one distal branch found beyond the boundary of the simulated lesion. In the remaining 3 placements (25.0 %), the capture rate was classified as “none,” as the medial branch trunk and all distal branches transited beyond the simulated lesion boundary. Refined fluoroscopic landmarks proposed were the lateral boundary of mammillary process (AP view); the mamillo-accessory notch/inferior boundary of facet joint line (oblique view); and the inferior aspect of the mammillary process (lateral view).</div></div><div><h3>Conclusions</h3><div>This anatomy optimization study used dissection, imaging correlation, and high-fidelity modelling to assess cannula placement for capture of the medial branch at the sub-mammillary fossa for lumbar facet joint denervation. Based on the present analysis, refined fluoroscopic landmarks were proposed for further investigation.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100586"},"PeriodicalIF":0.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physician compensation rates and gender disparities in interventional spine and pain practices: Insights from a Spine Intervention society survey study","authors":"Allen S. Chen ,&nbsp;Jonathan T. Droessler ,&nbsp;Jennifer Leet ,&nbsp;Byron Schneider ,&nbsp;Masaru Teramoto ,&nbsp;Newaj M. Abdullah ,&nbsp;Alexandra E. Fogarty ,&nbsp;Zachary L. McCormick","doi":"10.1016/j.inpm.2025.100583","DOIUrl":"10.1016/j.inpm.2025.100583","url":null,"abstract":"<div><h3>Summary of background data</h3><div>Physician compensation in the U.S. varies widely across specialties. Little is known about compensation patterns among U.S. interventional pain and spine physicians. Understanding these disparities is essential to address inequities and inform career decisions for physicians.</div></div><div><h3>Objectives</h3><div>This study aimed to assess the compensation landscape of U.S. interventional pain and spine physicians, identify key factors influencing compensation, and investigate the role of gender and practice experience in shaping salary outcomes.</div></div><div><h3>Methods</h3><div>A survey was conducted among members of the International Pain and Spine Interventional Society (IPSIS), focusing on demographics, clinical practice characteristics, and compensation details. A Poisson regression model was used to identify predictors of physician compensation.</div></div><div><h3>Results</h3><div>Survey respondents were primarily specialized in physical medicine and rehabilitation (PM&amp;R) (76.1 %) and had completed fellowship training (84.8 %). Compensation ranged widely, with most physicians earning between $250,000 and $450,000. Four main predictors of compensation were identified: years in practice, compensation model, gender, and first job salary. Physicians with 3–20 years in practice (vs. 0–2 years) and higher first job salaries earned significantly more, while female physicians earned 29 % less than their male counterparts.</div></div><div><h3>Discussion/conclusion</h3><div>This study highlights notable trends in compensation among U.S. interventional pain and spine physicians, with years of practice and first job salary as significant predictors. Female gender was associated with a 29 % lower income compared to male counterparts. These findings suggest the need for further exploration into the factors that drive compensation in this field and for initiatives aimed at addressing gender disparities to ensure more equitable compensation.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100583"},"PeriodicalIF":0.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the red: Diagnostic dilemma of erythema and diffuse body rash post- intrathecal baclofen pump implantation","authors":"Chelsey Hoffmann,&nbsp;Annie Howrigon,&nbsp;Jennifer Hollister,&nbsp;William D. Mauck,&nbsp;Oludare O. Olatoye","doi":"10.1016/j.inpm.2025.100584","DOIUrl":"10.1016/j.inpm.2025.100584","url":null,"abstract":"<div><div>Intrathecal drug delivery system (IDDS) infections can be localized to the pump pocket site and/or the catheter insertion site or become systemic, all potentially resulting in IDDS explant. Given the well-established effectiveness of IDDS for chronic non-cancer pain, cancer-associated pain, and spasticity, clinicians must differentiate between localized and systemic post-operative IDDS infections, as well as identify other causes of post-surgical skin irritation while avoiding unnecessary device explanation and therapy interruption.</div><div>In this letter-to-the-editor, we describe and discuss the importance of taking a thorough patient history and utilizing both critical clinical decision-making as well as expertise from other subspecialists to care for IDDS patients and navigate problematic skin reactions following implant.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100584"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluoroscopy-guided suprascapular and subscapular articular nerve blocks for chronic shoulder pain: A 12-week observational study","authors":"Anuj Jain ,&nbsp;Jithin K.J. ,&nbsp;Harish Kumar ,&nbsp;Radha Sarawagi ,&nbsp;Ashutosh Kaushal ,&nbsp;Swapnil Kumar Barasker","doi":"10.1016/j.inpm.2025.100582","DOIUrl":"10.1016/j.inpm.2025.100582","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic shoulder pain is a common musculoskeletal complaint. This study evaluates the effectiveness of fluoroscopy-guided suprascapular (SSN) and subscapular (SCN) articular branch blocks in managing chronic shoulder pain. The primary objective was to assess pain relief using a numerical rating scale (NRS) and functional improvement using Shoulder Pain and Disability Index (SPADI) over 12 weeks.</div></div><div><h3>Methods</h3><div>This prospective, single-arm observational study included 70 adults with chronic shoulder pain (≥3 months) meeting predefined criteria. All patients underwent fluoroscopy-guided SSN and SCN articular branch blocks with bupivacaine (2 ml, 0.5 %) and triamcinolone (0.5 ml, 20 mg) per site. NRS and SPADI were recorded at baseline and biweekly for 12 weeks. Secondary outcomes included range of motion (ROM) improvements and night pain resolution. Statistical analysis involved repeated measures ANOVA for normally distributed data and non-parametric tests for skewed data (p &lt; 0.05 considered significant).</div></div><div><h3>Results</h3><div>At 12 weeks, 78 % of patients achieved ≥50 % pain reduction. Mean NRS decreased from 7.6 ± 1.1 to 3.9 ± 1.1, while SPADI pain and disability scores improved by 57.1 % and 57.4 %, respectively (p &lt; 0.001). Night pain resolved in all affected patients within two weeks. Repeated measures ANOVA confirmed significant improvements in pain and disability scores (p &lt; 0.001). Mean lateral abduction improved by 29° (95 % CI: 22.8°–35.2°, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Fluoroscopy-guided SSN and SCN articular branch blocks provide significant pain relief and functional improvement in chronic shoulder pain, offering a potential alternative to intra-articular injections or surgery in select patients.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100582"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143807160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multisociety response to The BMJ publications on interventional spine procedures for chronic back and neck pain","authors":"Belinda Duszynski","doi":"10.1016/j.inpm.2025.100577","DOIUrl":"10.1016/j.inpm.2025.100577","url":null,"abstract":"","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100577"},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143799138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety practices for interventional pain procedures: Epidural and sacroiliac interventions","authors":"Stephan Klessinger ,&nbsp;Nathaniel M. Schuster ,&nbsp;Patrick H. Waring ,&nbsp;Yakov Vorobeychik ,&nbsp;Byron J. Schneider ,&nbsp;Stephen C. Johnson ,&nbsp;Marc K. Maes ,&nbsp;Clark C. Smith ,&nbsp;Ameet Nagpal ,&nbsp;International Pain and Spine Intervention Society","doi":"10.1016/j.inpm.2025.100579","DOIUrl":"10.1016/j.inpm.2025.100579","url":null,"abstract":"","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100579"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143767467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior allograft sacroiliac joint fusion with pre-operative mapping","authors":"Chris Bovinet ,&nbsp;Robert Moghim ,&nbsp;Max Y. Jin ,&nbsp;Alaa Abd-Elsayed","doi":"10.1016/j.inpm.2025.100581","DOIUrl":"10.1016/j.inpm.2025.100581","url":null,"abstract":"<div><h3>Background</h3><div>Low back pain is a highly prevalent and disabling condition. Sacroiliac joint dysfunction is prevalent in up to 62 % of some populations and is a common origin of low back pain. The posterior approach for minimally invasive sacroiliac joint fusion with an allograft is still relatively novel, with limited studies examining its safety and efficacy.</div></div><div><h3>Objective</h3><div>The objective of our study was to analyze changes in pain and opioid usage for patients who underwent this procedure with pre-operative mapping after exhausting conservative treatment methods.</div></div><div><h3>Methods</h3><div>This was a single-center, retrospective study with all cases completed by a single interventional pain physician. Outcomes regarding pain and opioid usage were extracted from electronic medical records, Georgia Prescription Drug Monitoring Program reports, and all other available state databases for 208 consecutive patients who underwent the minimally invasive sacroiliac joint fusion procedure with the LinQ Fusion Implant (PainTeq, Tampa, FL) after pre-operative mapping between August 2019 and October 2022. Pain was assessed using the Numerical Rating Scale (NRS), and opioid consumption was measured using Morphine Milligram Equivalents (MME).</div></div><div><h3>Results</h3><div>NRS scores decreased from 7.23 ± 1.82 at baseline to 1.16 ± 1.35 at the final available follow-up (p &lt; 0.001). Pain improvements ranged from 40 to 100 %, and all patients reported at least some improvement post-intervention. 205 of the 208 patients reported an improvement in pain of at least 50 %. MME reduced from 20.74 ± 26.33 mg to 10.00 ± 18.69 mg (p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Posterior allograft sacroiliac joint fusion significantly reduces pain and opioid consumption. Pre-operative mapping is beneficial but requires more evidence to elucidate its role in optimizing implant placement.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100581"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143767466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective single arm cohort study evaluating the efficacy of lumbar medial branch radiofrequency ablation using a multi-tined probe and perpendicular approach","authors":"Omar Rachdi ,&nbsp;Andrew Stephens ,&nbsp;Amanda N. Cooper ,&nbsp;Brook Martin ,&nbsp;Robert Burnham ,&nbsp;Aaron M. Conger ,&nbsp;Zachary L. McCormick ,&nbsp;Taylor R. Burnham","doi":"10.1016/j.inpm.2025.100575","DOIUrl":"10.1016/j.inpm.2025.100575","url":null,"abstract":"<div><h3>Summary of background data</h3><div>Lumbar medial branch radiofrequency ablation (LMBRFA) is an effective treatment for facet joint pain. LMBRFA efficacy was originally demonstrated using a parallel technique. Newly developed RFA probes (<em>e.g.</em>, Trident) allow a perpendicular approach (P-LMBRFA), which may simplify the RFA technique and lead to superior treatment success rates. However, further investigation is necessary to determine whether these technologies are associated with improved patient outcomes.</div></div><div><h3>Objectives</h3><div>Evaluate the effectiveness of P-LMBRFA in patients with confirmed facet pain.</div></div><div><h3>Methods</h3><div>In this retrospective single-arm cohort study, electronic medical records were used to identify consecutive patients with ≥80 % dual medial branch block-confirmed pain relief who underwent first-time P-LMBRFA between 2016 and 2022. Primary outcomes were ≥50 % Numerical Rating Scale (NRS) pain improvement and the minimal clinically important difference (MCID) on the Pain Disability Quality-of-Life Questionnaire (PDQQ) at 3 months post-treatment. Secondary outcomes included the duration and mean retrospective percentage of pain relief after a successful index P-LMBRFA in individuals who reported a return of their index symptoms.</div></div><div><h3>Results</h3><div>174 participants (60.3 % female, 61.3 ± 14.2 years of age, BMI 29.5 ± 6.7 kg/m²) were analyzed. Success rates for ≥50 % NRS reduction and MCID on the PDQQ at 3 months were 50.6 % (95 % CI = 43.3–57.9 %) and 50.0 % (95 % CI = 42.8–57.2 %), respectively. Of the 88 successful P-LMBRFAs, 60 patients experienced a return of symptoms after 8.7 ± 3.6 months and reported a retrospective mean percentage pain relief of 81.8 % ± 15.8 %.</div></div><div><h3>Discussion/conclusion</h3><div>Following P-LMBRFA, approximately 50 % of patients reported improvement in pain and disability measures. Extensive, prospective research comparing long-term outcomes of P-LMBRFA and parallel LMRBFA is warranted.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100575"},"PeriodicalIF":0.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factfinders for patient safety: Epidural steroid injections in the setting of severe cervical central and neuroforaminal stenosis","authors":"Patricia Zheng ,&nbsp;Aditya Raghunandan ,&nbsp;Mathew Saffarian ,&nbsp;David Levi ,&nbsp;the International Pain and Spine Intervention Society's Patient Safety Committee","doi":"10.1016/j.inpm.2025.100580","DOIUrl":"10.1016/j.inpm.2025.100580","url":null,"abstract":"<div><div>This FactFinder presents a brief summary of the evidence surrounding the safety of epidural steroid injections in patients with severe cervical central canal or neural foraminal stenosis. With proper consideration of anatomy, level, and approach, cervical epidural steroid injection risks may be mitigated in a patient with severe cervical central canal and/or neuroforaminal spinal stenosis.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100580"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}