Interventional Pain Medicine最新文献

{"title":"Fluoroscopy-guided celiac plexus block – Trans-Aortic approach","authors":"Kelly Li ,&nbsp;Ivy Liu ,&nbsp;Robert Jason Yong ,&nbsp;David Hao","doi":"10.1016/j.inpm.2025.100644","DOIUrl":"10.1016/j.inpm.2025.100644","url":null,"abstract":"<div><div>Transaortic celiac plexus block is an image-guided procedure used to manage refractory abdominal pain, often related to malignancy or chronic conditions like pancreatitis. This educational video demonstrates the transaortic approach for celiac plexus block under fluoroscopic guidance. The video reviews indications, relevant anatomy, procedural steps, and potential complications. This content is intended to supplement formal instruction and enhance understanding of a targeted technique used in the management of abdominal pain.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 4","pages":"Article 100644"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145270421","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":"Intra-articular cervical facet joint corticosteroid injections in patients with increased peri-facet MRI STIR signal. A prospective, multi-center case series","authors":"Joshua Levin ,&nbsp;Kevin Barrette ,&nbsp;Cyrus Ghaffari ,&nbsp;Reza Ehsanian ,&nbsp;Jayme Koltsov ,&nbsp;Christina Giacomazzi ,&nbsp;Nitin Prabhakar ,&nbsp;Lisa Huynh ,&nbsp;Matthew Smuck ,&nbsp;William Summers ,&nbsp;Byron Schneider","doi":"10.1016/j.inpm.2025.100646","DOIUrl":"10.1016/j.inpm.2025.100646","url":null,"abstract":"<div><h3>Background</h3><div>Intra-articular cervical facet joint corticosteroid injections are commonly performed, yet studies demonstrating benefit are limited.</div></div><div><h3>Purpose</h3><div>To evaluate success rates of intra-articular cervical facet joint corticosteroid injections in patients with increased peri-facet edema as demonstrated by MRI with STIR sequences.</div></div><div><h3>Study design</h3><div>Preliminary, prospective, multi-center case series.</div></div><div><h3>Patient sample</h3><div>Thirty-three patients from three independent spine centers.</div></div><div><h3>Methods</h3><div>Consecutive patients were enrolled with axial neck pain and peri-facet joint edema on MRI with STIR sequences when undergoing intra-articular cervical facet joint corticosteroid injections. Outcomes were prospectively collected at 2-4-weeks and at 3-months post-injection. The primary outcome was the proportion of patients with at least 50 % improvement in the numeric rating scale (NRS) pain score. Neck disability index (NDI) and global perception of change (GPC) were evaluated as secondary outcomes.</div></div><div><h3>Results</h3><div>At 2-4-weeks post-injection, 64 % [95 %CI: 46–79 %] of the 28 patients with follow-up data met criteria for success (≥50 % improvement in NRS). 86 % [95 %CI: 69–94 %] reported that they were better or much better on the GPC, and mean NDI improved from 19.3 to 8.9. At 3-months post-injection, 35 % [95 %CI: 19–54 %] of the 26 patients with follow-up data met criteria for success, and 50 % [95 %CI: 32–68 %] reported that they were better or much better on the GPC. Mean NDI at 3-months was 11.0.</div></div><div><h3>Conclusions</h3><div>Intra-articular cervical facet joint corticosteroid injections may provide short-term relief of neck pain in patients with peri-facet edema as demonstrated by MRI with STIR sequences. Intermediate-term results are less encouraging.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 4","pages":"Article 100646"},"PeriodicalIF":0.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145270422","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":"Patient-reported outcomes following radiofrequency ablation of the hip: a retrospective study","authors":"Melissa Schwartz ,&nbsp;Alejandra Cardenas-Rojas ,&nbsp;Michael Suarez ,&nbsp;Anna Megenhardt ,&nbsp;Ahmed Khawer ,&nbsp;Annie Yang ,&nbsp;Eric Muneio ,&nbsp;Pranamya Suri ,&nbsp;Akhil Chhatre","doi":"10.1016/j.inpm.2025.100645","DOIUrl":"10.1016/j.inpm.2025.100645","url":null,"abstract":"<div><h3>Background</h3><div>Chronic hip pain, primarily caused by osteoarthritis, is a prevalent condition that significantly reduces quality of life for many individuals. Radiofrequency ablation (RFA) has emerged as a promising, minimally invasive treatment targeting sensory nerves around the hip joint to provide sustained relief. However, guidelines for selecting suitable patients and predicting outcomes remain unclear.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate patient-reported pain outcomes following hip RFA and to identify pre-procedure patient factors influencing treatment response.</div></div><div><h3>Methods</h3><div>In this retrospective study conducted at a tertiary academic center, data was collected from patients undergoing unilateral or bilateral RFA of the articular branches of the obturator and femoral nerves between August 2019 and August 2024. Information collected included demographics, osteoarthritis severity, opioid and antidepressant use, and pre- and post-procedure numeric rating scale (NRS) scores for pain. Primary outcome measures were pre-post difference NRS score, considering clinically meaningful a ≥2-point improvement in NRS and ≥50 % pain reduction. Secondary outcomes included patient perceptions measured using the Patient Global Impression of Change (PGIC) scale. Logistic regression analysis was conducted to identify predictors of treatment success.</div></div><div><h3>Results</h3><div>Fifty-four patients (64 procedures) participated, predominantly female (64.8 %), with an average age of 68 years old and BMI of 31.43 kg/m². A significant median reduction of 2.5 points in NRS was reported post-procedure (p &lt; 0.001). Overall, 56.25 % of patients achieved a clinically meaningful ≥2-point NRS reduction, and 43.75 % experienced ≥50 % pain reduction. Approximately 66 % of patients reported improvement on the PGIC scale. The average duration of pain relief among responders was six months. Patients without pre-procedure opioid use (OR = 0.24, p = 0.027) and those with higher BMI (p = 0.04) had significantly better outcomes.</div></div><div><h3>Conclusion</h3><div>Hip RFA demonstrates potential in reducing pain levels and improving patient-reported outcomes in individuals with chronic hip pain. Better outcomes were notably associated with the absence of pre-procedure opioid use and higher BMI. Further research is needed to refine patient selection guidelines and to evaluate functional improvements following the procedure.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 4","pages":"Article 100645"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145196029","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":"True AP imaging during lumbar medial branch radiofrequency neurotomy: Interobserver reliability","authors":"Patrick H. Waring ,&nbsp;W. Evan Rivers ,&nbsp;Duncan L. Bralts ,&nbsp;D. Keith Granger II ,&nbsp;Timothy P. Maus ,&nbsp;Belinda Duszynski ,&nbsp;Michael B. Furman","doi":"10.1016/j.inpm.2025.100630","DOIUrl":"10.1016/j.inpm.2025.100630","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;True segmental imaging, in AP and lateral planes, is necessary to accurately place an RF cannula contiguous with the targeted medial branch and achieve effective pain relief with lumbar radiofrequency neurotomy (LMBRFN). True lateral imaging and its interobserver reliability during LMBRFN have been described. A complementary true AP imaging technique has recently been described, but its interobserver reliability has yet to be studied.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This study aims to determine the interobserver reliability of the recently described true AP imaging technique for LMBRFN.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;After obtaining IRB exemption, true and untrue AP images were collected from consecutive LMBRFN procedures performed during the normal course of the primary author's (PW) practice. A 100-slide testing set was formulated. Each slide contained a true and an untrue counterpart AP image depicting the same single-level RF cannula placement targeting an L3 or L4 medial branch or an L5 dorsal ramus. After slide randomization, a Google Forms test was created to capture observer responses. Two sets of observers were used to represent novice (DB,KG) and experienced (MF,ER) observers. Each observer independently reviewed the testing slide set, recording a total of 300 responses for the three binary decisions on each slide: which image was true, which corrective maneuver (oblique or tilt) was required to make the untrue image a true image, and finally, which was the direction of the appropriate corrective maneuver (right or left oblique/cranial or caudal tilt). Each observer's test was compared to the answer key established by two non-observer authors (PW,TM). Interobserver agreement for both the novice and experienced groups was determined for each of the three decisions using the Kappa score calculation. Individual observer performance was also determined.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;For the determination of the true image, the novice group's interobserver agreement (Kappa score) was 0.98 (0.94,1.0); the experienced group's was 0.96 (0.91,1.0). For the oblique or tilt corrective maneuver decision, the novice group's Kappa was 1.0; the experienced group's was 0.98 (0.94,1.0). For the direction of the oblique corrective maneuver, the novice group's Kappa was 1.0; the experienced group's was 0.88 (0.75,1.0). For the direction of the tilt corrective maneuver, the novice group's Kappa was 0.96 (0.88,1.0); the experienced group's was 0.92 (0.81,1.0). Individual observer performance data on the total of 300 decisions ranged from 98% (an experienced observer) to 100% (a novice observer).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Obtaining true AP imaging for LMBRFN by the newly described technique is supported by significant interobserver reliability that ranges from substantial to perfect. This AP imaging technique, when combined with true lateral imaging, provides true lumbar segmental imaging. True ","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 3","pages":"Article 100630"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988349","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":"ChatGPT and low back pain - Evaluating AI-driven patient education in the context of interventional pain medicine","authors":"Ahmed Basharat ,&nbsp;Rohan Shah ,&nbsp;Nick Wilcox ,&nbsp;Gurpaij Tur ,&nbsp;Siddarth Tripati ,&nbsp;Prisha Kansal ,&nbsp;Niveah Gandhi ,&nbsp;Sreekrishna Pokuri ,&nbsp;Gabby Chong ,&nbsp;Charles A. Odonkor ,&nbsp;Narayana Varhabhatla ,&nbsp;Robert Chow","doi":"10.1016/j.inpm.2025.100636","DOIUrl":"10.1016/j.inpm.2025.100636","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;ChatGPT and other Large Language Models (LLMs) are not only being more readily integrated into healthcare but are also being utilized more frequently by patients to answer health-related questions. Given the increased utilization for this purpose, it is essential to evaluate and study the consistency and reliability of artificial intelligence (AI) responses. Low back pain (LBP) remains one of the most frequently seen chief complaints in primary care and interventional pain management offices.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This study assesses the readability, accuracy, and overall utility of ChatGPT's ability to address patients' questions concerning low back pain. Our aim is to use clinician feedback to analyze ChatGPT's responses to these common low back pain related questions, as in the future, AI will undoubtedly play a role in triaging patients prior to seeing a physician.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;To assess AI responses, we generated a standardized list of 25 questions concerning low back pain that were split into five categories including diagnosis, seeking a medical professional, treatment, self-treatment, and physical therapy. We explored the influence of how a prompt is worded on ChatGPT by asking questions from a 4th grader to a college/reference level. One board certified interventional pain specialist, one interventional pain fellow, and one emergency medicine resident reviewed ChatGPT's generated answers to assess accuracy and clinical utility. Readability and comprehensibility were evaluated using the Flesch-Kincaid Grade Level Scale. Statistical analysis was performed to analyze differences in readability scores, word count, and response complexity.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;How a question is phrased influences accuracy in statistically significant ways. Over-simplification of queries (e.g. to a 4th grade level) degrades ChatGPT's ability to return clinically complete responses. In contrast, reference and neutral queries preserve accuracy without additional engineering. Regardless of how the question is phrased, ChatGPT's default register trends towards technical language. Readability remains substantially misaligned with health literacy standards. Verbosity correlates with prompt type, but not necessarily accuracy. Word count is an unreliable proxy for informational completeness or clinical correctness in AI outputs and most errors stem from omission, not commission. Importantly, ChatGPT does not frequently generate false claims.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;This analysis complicates the assumption that “simpler is better” in prompting LLMs for clinical education. Whereas earlier work in structured conditions suggested that plain-language prompts improved accuracy, our findings indicate that a moderate reading level, not maximal simplicity, yields the most reliable outputs in complex domains like pain. This study further supports that AI LLMs can be integrated ","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 3","pages":"Article 100636"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144925777","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":"The impact on fluoroscopic image review on perceived benefit, patient satisfaction, and short-term improvement following lumbosacral epidural steroid injections","authors":"Tahsin Choudhury,&nbsp;John Jung,&nbsp;Monica Barnes,&nbsp;SriKrishna Chandran,&nbsp;James T. Eckner,&nbsp;Michael Geisser,&nbsp;David J. Kohns","doi":"10.1016/j.inpm.2025.100640","DOIUrl":"10.1016/j.inpm.2025.100640","url":null,"abstract":"<div><h3>Background</h3><div>Interventional spine and pain physicians rarely review fluoroscopic images with their patients following spine procedures. Despite high patient satisfaction with these procedures, there may be further steps to enhance the patient experience.</div></div><div><h3>Objectives</h3><div>The purpose of this study is to analyze the impact of physician's post-procedure fluoroscopic image review on perceived benefit, patient satisfaction, and short-term improvement.</div></div><div><h3>Methods</h3><div>This single blinded prospective comparative study evaluated post-procedure questionnaires following non-sedation lumbosacral transforaminal epidural steroid injection (TFESIs). The control group received a scripted verbal explanation of the procedure results. The intervention group received a similar explanation that was enhanced with a review of the fluoroscopic procedure images. The perceived benefit was assessed by asking the participants to rate the degree of helpfulness of image review. A modified Press Ganey Satisfaction Questionnaire was used to assess patient satisfaction. Short-term improvement following the procedure was measured at two weeks with a Patient Global Impression of Change (PGIC). In the case of missing PGIC data, manual chart reviews were conducted to assess outcomes.</div></div><div><h3>Results</h3><div>The control group (no image review) included 70 participants, while the intervention group (image reviewed) included 71. There were 95.8 % of the intervention group that rated their actual image review as helpful to very helpful, while 68.6 % of the control group felt that image review would have been helpful to very helpful. The intervention group also reported significantly higher confidence in their provider (p = 0.03). There was no significant difference between groups in other domains of patient satisfaction or short-term improvement following the spine procedure.</div></div><div><h3>Conclusion</h3><div>Consistent with prior literature, all participants reported high satisfaction following a lumbosacral TFESI. This study demonstrated that a brief post-procedure image review was highly beneficial and improved confidence in the care providers, whereas the control group likely underestimated the potential helpfulness of receiving an image review. Further studies are required to explore the best use of post-procedure image review and the potential further impact on patient-centered care.</div></div><div><h3>Registered</h3><div>ClinicalTrials.gov <span><span>NCT05884684</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 3","pages":"Article 100640"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144920149","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":"True segmental lumbar imaging: Technical precision matters","authors":"Vinil Shah MD","doi":"10.1016/j.inpm.2025.100641","DOIUrl":"10.1016/j.inpm.2025.100641","url":null,"abstract":"","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 3","pages":"Article 100641"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922657","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":"Long term management of refractory angina due to cardiac syndrome X with peripheral nerve field stimulation (PNfS)","authors":"Andrea Perera ,&nbsp;Teo Goroszeniuk ,&nbsp;Keyoumars Ashkan","doi":"10.1016/j.inpm.2025.100639","DOIUrl":"10.1016/j.inpm.2025.100639","url":null,"abstract":"","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 3","pages":"Article 100639"},"PeriodicalIF":0.0,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908287","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":"Letter to the editor regarding \"Trends in lumbar epidural injection selection: A survey of practitioner preferences and practice patterns\"","authors":"Ryan Triglia ,&nbsp;Andrew Walrond ,&nbsp;Jesse Wagner ,&nbsp;Paul M. Kitei ,&nbsp;Jeffrey Boyd ,&nbsp;Jeremy I. Simon","doi":"10.1016/j.inpm.2025.100638","DOIUrl":"10.1016/j.inpm.2025.100638","url":null,"abstract":"","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 3","pages":"Article 100638"},"PeriodicalIF":0.0,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908288","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":"Letter to the editor regarding “Trends in lumbar epidural injection selection: A survey of practitioner preferences and practice patterns”","authors":"Parth Aphale,&nbsp;Himanshu Shekhar,&nbsp;Shashank Dokania","doi":"10.1016/j.inpm.2025.100637","DOIUrl":"10.1016/j.inpm.2025.100637","url":null,"abstract":"","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 3","pages":"Article 100637"},"PeriodicalIF":0.0,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908289","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}