Interventional Pain Medicine最新文献

{"title":"Corrigendum to “Evaluating the effectiveness of genicular radiofrequency ablation for chronic knee pain using the patient-reported outcomes measurement information system (PROMIS) global health-physical health domain: Results of a cross-sectional cohort study” [Intervent Pain Med 4 (2025) 100539]","authors":"Todd K. Brown , Marc A. Caragea , Margaret Beckwith , Amelia Ni , Ling Chen , Tyler Woodworth , Michael Blatt , Cole Cheney , Daniel Carson , Keith Kuo , Dustin Randall , Emily Y. Huang , Andrea Carefoot , Megan Mills , Amanda N. Cooper , Allison Glinka Przybysz , Taylor Burnham , Aaron M. Conger , Zachary L. McCormick","doi":"10.1016/j.inpm.2025.100570","DOIUrl":"10.1016/j.inpm.2025.100570","url":null,"abstract":"","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100570"},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697865","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":"Assessing injectate spread in ultrasound-guided capsular hydro dilatation for adhesive capsulitis: A comparative MRI study of anterior rotator interval vs. posterior glenohumeral joint approaches","authors":"Nimish Mittal ,&nbsp;David Salonen ,&nbsp;Philip Peng","doi":"10.1016/j.inpm.2025.100557","DOIUrl":"10.1016/j.inpm.2025.100557","url":null,"abstract":"<div><div>Adhesive capsulitis is a self-limiting condition of the shoulder, characterized by pain and limited range of motion (ROM). Intra-articular steroid injection and hydrodistension of the joint capsule are effective strategies for pain relief and improvement of ROM. Several randomized studies indicate that anterior rotator cuff interval (RCI) injections yield better outcomes than posterior glenohumeral (GH) joint injections. No study has examined the differences in injectate spread patterns between anterior RCI and posterior GH joint approaches. This study involved three patients with adhesive capsulitis who received ultrasound-guided shoulder joint injections with capsular hydrodilatation, utilizing 10 cc, via either the anterior RCI approach or the posterior GH joint approach. The injectate comprised 1 mL (80 mg) methylprednisolone acetate, 4 mL of 2 % lidocaine, and 5 mL of saline mixed with gadolinium contrast. Immediately following the injection, an MRI of the shoulder was performed to evaluate the distribution of the injectate. Injections via the anterior RCI approach exhibited significant intra-capsular spread and vital pathological intra-capsular and pericapsular structures. In contrast, posterior GH joint injections revealed restricted spread, mainly enlarging the joint recess without involvement of the pericapsular ligaments. This study highlights the distribution of injectate following an ultrasound-guided anterior shoulder joint injection, demonstrating that the anterior RCI approach effectively disperses a 10 mL injectate to the intra-capsular synovial lining and key pericapsular structures. The findings suggest that technique selection significantly impacts injectate distribution in adhesive capsulitis, with a 10 mL volume achieving optimal capsular distension without rupture.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 1","pages":"Article 100557"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527505","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":"Efficacy and safety of vertebral augmentation techniques in patients with osteoporotic vertebral compression fractures: A single center, retrospective, observational study","authors":"Eliezer Soto ,&nbsp;Michael F. Esposito","doi":"10.1016/j.inpm.2025.100568","DOIUrl":"10.1016/j.inpm.2025.100568","url":null,"abstract":"<div><h3>Background</h3><div>Back pain secondary to osteoporotic vertebral compression fractures (OVCF) is a common global health problem that is frequently overlooked. For some patients, conservative management (CM) is inadequate to treat the pain associated with OVCF. This subset of patients are often candidates for interventional vertebral augmentation techniques (VAT). Multiple studies have shown significant pain reduction, height restoration, reduction in hospitalization time, morbidity and mortality in patients treated with VAT as compared with those patients treated with CM. This study examines if the previously published trials are consistent with outcomes in a real-world cohort of patients in interventional pain practices following VAT.</div></div><div><h3>Objectives</h3><div>The purpose of this retrospective databased analysis was to further investigate the efficacy and safety of percutaneous vertebral augmentation techniques in patients suffering from osteoporotic vertebral compression fractures in our center.</div></div><div><h3>Study design</h3><div>Retrospective study.</div></div><div><h3>Setting</h3><div>A single-center study.</div></div><div><h3>Patients and methods</h3><div>We have included data from a total of 42 patients (26 females, 16 males) with diagnosis of OVCF that received VAT at our center between January 2023 and June 2024. Efficacy data included pre-procedure, 2-week, 1-month and 3-month follow-up numerical rating scale (NRS) pain scores when available.</div></div><div><h3>Results</h3><div>The mean pain score using NRS was 7.5 (n = 45), 3.24 (n = 44), 3.65 (n = 21) and 2.7 (n = 15) at pre-procedure, 2-week, 1-month and 3-month follow-up (P &lt; 0.001), respectively. At the 2-week follow up, 44 %, 16 %, 20 % and 13 % of patients (n = 45) had NRS pain score reduction between 76 and 100 %, 51–75 %, 26–50 % and 0–25 % (P ≤ 0.05), respectively. At the 1-month follow-up visit, 24 %, 33 %, 14.3 % and 24 % of patients (n = 21) had NRS pain score reduction between 76 and 100 %, 51–75 %, 26–50 % and 0–25 % (P ≤ 0.05), respectively. At the 3-month follow-up visit, 60 %, 6.7 %, 6.7 % and 20 % of patients (n = 15) had NRS pain score reduction between 76 and 100 %, 51–75 %, 26–50 % and 0–25 % (P ≤ 0.05), respectively. This indicates significant differences in NRS pain scores across the different time points. There was a high dropout rate at the 3-month follow up visit most likely due to patient's pain improving post procedure.</div></div><div><h3>Limitations</h3><div>This was a single-center retrospective study with a small sample size and relatively short follow-up time.</div></div><div><h3>Conclusion</h3><div>VAT are effective and safe procedures for patients suffering from OCVF. However, proceduralists must be aware of patient-specific risk factors to prevent possible complications.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 1","pages":"Article 100568"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143547913","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":"The effectiveness of cervical medial branch radiofrequency neurotomy using a perpendicular approach with a three-tined probe: A single-arm, retrospective cohort study","authors":"David Civitarese ,&nbsp;Andrew Stephens ,&nbsp;Timothy M. Curtis ,&nbsp;Chase Young ,&nbsp;Alexa G. Ries ,&nbsp;Amanda N. Cooper ,&nbsp;Brook Martin ,&nbsp;Alycia Amatto ,&nbsp;Robert S. Burnham ,&nbsp;Aaron M. Conger ,&nbsp;Zachary L. McCormick ,&nbsp;Taylor R. Burnham","doi":"10.1016/j.inpm.2025.100572","DOIUrl":"10.1016/j.inpm.2025.100572","url":null,"abstract":"<div><h3>Background</h3><div>Cervical medial branch radiofrequency neurotomy (CMBRFN) with a parallel approach has been proven to be an effective treatment for zygapophyseal joint-mediated cervical pain. Technological advancements in radiofrequency probe design have allowed for a perpendicular approach to electrode placement. However, the effectiveness of the perpendicular approach remains to be fully understood.</div></div><div><h3>Objectives</h3><div>Evaluate the effectiveness of CMBRFN with a perpendicular approach (pCMBRFN) in patients with confirmed zygapophyseal joint-mediated cervical pain.</div></div><div><h3>Methods</h3><div>This single-arm, retrospective cohort study included patients identified between 2016 and 2022 who underwent pCMBRFN after demonstrating ≥80 % pain relief with two consecutive diagnostic medial branch blocks (MBB). Primary outcomes were ≥50 % patient-reported numeric rating scale (NRS) pain relief and minimal clinically important difference (MCID) on the Pain Disability Quality-Of-Life Questionnaire-Spine (PDQQ-S) at 3 months post-procedure. Secondary outcomes were mean patient-reported retrospective percentage pain relief and duration of relief after a successful pCMBRFN in individuals who presented for repeat pCMBRFN upon return of their symptoms.</div></div><div><h3>Results</h3><div>A total of 52 participants (63.5 % female; mean age 55.9 ± 10.9 years; mean BMI 26.8 ± 5.2 kg/m²) were analyzed. At 3 months post-procedure, ≥50 % NRS pain reduction and MCID on PDQQ-S were both reported by 34 patients (65.4 % [95%CI 51.8–76.9]). Of the 34 patients with successful treatment response, 15 had return of symptoms after an average of 8.8 ± 2.5 months with a reported mean percentage pain relief of 86.0 ± 14.9 %.</div></div><div><h3>Conclusion</h3><div>Within this cohort, pCMBRFN demonstrated effectiveness by reducing pain and disability in over 65 % of patients with confirmed cervical zygapophyseal joint-mediated pain at 3 months. Patients with successful treatment outcomes whose index symptoms eventually returned reported an average pain reduction of 86 % lasting approximately 9 months. Larger prospective studies with long-term follow-up are needed to confirm these results.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 1","pages":"Article 100572"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683662","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":"The effect of hybrid ultrasound/fluoroscopy guidance vs only fluoroscopy guidance on procedure time and radiation exposure in caudal epidural steroid injections","authors":"Serdar Kesikburun ,&nbsp;Şahide Eda Artuç ,&nbsp;Esra Çelik Karbancioğlu ,&nbsp;Bilge Kesikburun ,&nbsp;Emre Adigüzel ,&nbsp;Evren Yaşar","doi":"10.1016/j.inpm.2025.100567","DOIUrl":"10.1016/j.inpm.2025.100567","url":null,"abstract":"<div><h3>Background</h3><div>Ultrasonography guidance have had a rapid increase in its popularity for caudal epidural steroid injections. However, unlike fluoroscopy, ultrasound cannot reliably detect intravascular or intradural distribution of the medication. Therefore, the practitioners cannot be entirely certain about the accuracy of the procedure. A hybrid technique may eliminate these drawbacks. The primary objective of this study is to evaluate the effect of hybrid ultrasound/fluoroscopy guidance on procedure time, fluoroscopy duration, and radiation exposure during caudal epidural injections, compared to the conventional method of fluoroscopy-only guidance.</div></div><div><h3>Methods</h3><div>In this prospective randomized controlled trial, 65 patients who were undergoing caudal epidural steroid injection randomized into two groups: the hybrid ultrasound/fluoroscopy group [Group 1 (n = 32)] and the fluoroscopy-only group [Group 2 (n = 33)]. Kerma area product (KAP), elapsed time of the needle insertion into sacral hiatus, elapsed time of the entire procedure and fluoroscopy time were measured. Numeric Rating Scale (NRS) for pain level and Oswestry Disability Index (ODI) were also assessed before the procedure and two weeks later.</div></div><div><h3>Results</h3><div>Radiation exposure measured using fluoroscopy time (group 1 = 0.06 ± 0.01 min; group 2 = 0.09 ± 0.03 min) and KAP (group 1 = 43.73 ± 16.90 cGy cm²; group 2 = 72.39 ± 32.75 cGy cm²) was significantly lower in group 1 compared to group 2 (p &lt; 0.001 for both). Elapsed time of the needle insertion into sacral hiatus (T1) (group 1 = 2.82 ± 1.07 min; group 2 = 3.73 ± 2.47) was shorter in the group 1 compared to group 2 (p = 0.027). However, there was no significant difference in the entire procedure time (group 1 = 5.14 ± 1.55 min; group 2 = 5.86 ± 2.71 min) between group 1 and group 2 (p = 0.100). A significant improvement in NRS and ODI measurements was shown over time for both groups (p &lt; 0.001 for both). No significant interaction between group and time was identified concerning NRS (p = 0.177) and ODI (p = 0.207) scores. A total of 4 vascular uptake out of 65 procedures (6.1 %) were detected in both groups.</div></div><div><h3>Conclusions</h3><div>The hybrid guidance may offer a potentially safer method minimizing radiation risk compared to fluoroscopy-only guidance for caudal epidural steroid injections.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 1","pages":"Article 100567"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143547909","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":"Leukocyte poor platelet rich plasma vs leukocyte rich platelet rich plasma as a treatment for cervical facetogenic pain: A pooled analysis","authors":"David J. Allison ,&nbsp;Eldon Loh ,&nbsp;Robert Burnham ,&nbsp;Taylor Burnham ,&nbsp;Ashley Smith","doi":"10.1016/j.inpm.2025.100566","DOIUrl":"10.1016/j.inpm.2025.100566","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to compare the effectiveness and safety of leukocyte-poor platelet-rich plasma (LP-PRP) and leukocyte-rich platelet-rich plasma (LR-PRP) for the treatment of cervical facetogenic pain through a pooled analysis of two independent studies. The goal was to provide preliminary evidence comparing the effect on pain relief and functional improvement over time to help inform future research.</div></div><div><h3>Methods</h3><div>The pooled analysis integrated data from two studies: a prospective case series of LR-PRP (n = 36) and a randomized controlled trial (RCT) comparing LP-PRP (n = 21) with corticosteroid injections. Participants in both studies had chronic cervical facetogenic pain confirmed through medial branch blocks and were assessed at baseline, 3 months, and 6 months post-injection. Pain intensity was measured using the Numerical Pain Rating Scale (NRS), and functional disability was assessed using the Neck Disability Index (NDI). Linear mixed-effects models evaluated treatment effects over time, controlling for age, sex, and pain duration. Clinically important differences in pain and disability were determined. Adverse events were also recorded.</div></div><div><h3>Results</h3><div>Both PRP groups exhibited significant improvements in pain and functional outcomes. However, LR-PRP demonstrated superior efficacy at 6 months, with a greater reduction in NRS scores (β = −1.68, p &lt; 0.01, Cohen's d = −1.15) and NDI scores (β = −3.66, p = 0.02, Cohen's d = −0.94) compared to LP-PRP. A higher proportion of LR-PRP participants achieved clinically significant pain relief (≥2-point NRS reduction) and functional improvement (≥10 % NDI reduction) at 6-months. No significant differences were observed at 3 months. Adverse events were more common in the LP-PRP group, with 11 documented cases, including increased pain and muscle spasms, whereas the LR-PRP group reported no adverse events.</div></div><div><h3>Conclusion</h3><div>These preliminary findings suggest that LR-PRP appears to provide greater long-term benefits for cervical facetogenic pain compared to LP-PRP, with superior pain reduction, improved function, and a favorable safety profile. These findings suggest the higher leukocyte concentration in LR-PRP may enhance therapeutic outcomes for cervical pain. Further large-scale, randomized trials are necessary to confirm these results and establish standardized PRP preparation protocols.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 1","pages":"Article 100566"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577780","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":"Three-year results of the MOTION randomized controlled trial for treatment of lumbar spinal stenosis using the percutaneous mild® Procedure","authors":"Shrif J. Costandi ,&nbsp;Timothy R. Deer ,&nbsp;Timothy B. Chafin ,&nbsp;Christopher Kim","doi":"10.1016/j.inpm.2025.100561","DOIUrl":"10.1016/j.inpm.2025.100561","url":null,"abstract":"<div><h3>Objective</h3><div>The MOTION prospective, multicenter randomized controlled trial compares the outcomes of percutaneous image-guided lumbar decompression in combination with conventional medical management (CMM) to the use of CMM alone for the treatment of lumbar spinal stenosis with neurogenic claudication secondary to hypertrophic ligamentum flavum. The study includes extended follow-up for patients in both the treatment group and for those who crossed over from the control group to the treatment group.</div></div><div><h3>Methods</h3><div>The treatment group received the <em>mild</em>® Procedure (Vertos Medical, Aliso Viejo, CA, USA) in combination with nonsurgical CMM, while the active control group received CMM alone. There were no restrictions for either group regarding access to real-world CMM therapies. Patients reported outcomes using the Oswestry Disability Index (ODI), Zurich Claudication Questionnaire (ZCQ), and Numeric Pain Rating Scale (NPRS). Objective outcomes were measured using a validated Walking Tolerance Test (WTT), the incidence of subsequent lumbar spine interventions, and the occurrence of adverse events.</div></div><div><h3>Results</h3><div>Forty-eight patients initially receiving <em>mild</em> + CMM consented to extended follow-up and were available for 3-year follow-up. All outcomes for this group were significantly improved over baseline (p-values ranging from &lt;0.0001 to 0.0001). At 3-year, ODI, NPRS back and leg, ZCQ symptom severity, and physical function improved by 16.9, 3.0, 4.3, 0.8, and 0.6, respectively. Walking tolerance test demonstrated 274 % improvement from baseline, and only 4 (5.6 %) patients had received surgical intervention. No device- or procedure-related adverse events were reported.</div></div><div><h3>Conclusions</h3><div>MOTION 3-year follow-up results continue to demonstrate the safety and durability of the <em>mild</em> Procedure combined with CMM for early interventional treatment of symptomatic LSS. The absence of device or procedure-related adverse events further underscores the robust safety profile of the <em>mild</em> Procedure. Significant and substantial improvements in all the outcomes were observed from baseline to follow-up for patients treated with the <em>mild</em> Procedure. These results support the <em>mild</em> Procedure as an effective approach for early intervention in LSS treatment.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 1","pages":"Article 100561"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610413","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":"The effectiveness of balloon kyphoplasty compared to conservative treatment for osteoporotic vertebral compression fractures: A systematic review and meta-analysis","authors":"Sebastian Encalada ,&nbsp;Christine Hunt ,&nbsp;Belinda Duszynski ,&nbsp;Vafi Salmasi ,&nbsp;Paul Scholten ,&nbsp;Zirong Zhao ,&nbsp;George Rappard ,&nbsp;William Evan Rivers ,&nbsp;To-Nhu Vu ,&nbsp;Steven Lobel ,&nbsp;Adrian Popescu ,&nbsp;Larry J. Prokop ,&nbsp;D. Scott Kreiner","doi":"10.1016/j.inpm.2025.100569","DOIUrl":"10.1016/j.inpm.2025.100569","url":null,"abstract":"<div><h3>Background</h3><div>Osteoporotic vertebral compression fractures (OVCFs) are a common and often debilitating condition that significantly impacts quality of life and healthcare costs. While conservative treatment is often pursued initially after fracture, some patients experience severe pain refractory to conservative treatment. In these cases, minimally invasive vertebral augmentation procedures like balloon kyphoplasty (BKP) offer an alternative, but the benefits of BKP compared to conservative treatment remain unclear.</div></div><div><h3>Objectives</h3><div>To evaluate the effectiveness of BKP versus conservative treatment for pain, quality of life, and function in patients with painful OVCFs.</div></div><div><h3>Primary outcome</h3><div>Pain improvement up to 12 months after BKP.</div></div><div><h3>Secondary outcomes</h3><div>Functional improvement, adverse events, and vertebral body height restoration.</div></div><div><h3>Methods</h3><div>This analysis included randomized controlled trials and prospective comparative studies in which at least 100 participants reported pain outcomes following BKP for OVCFs. The risk of bias was assessed using standard tools, and the certainty of the evidence was evaluated using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach.</div></div><div><h3>Results</h3><div>BKP demonstrated superior pain reduction versus conservative treatment at 1 month (mean difference (MD): 2.32 [-3.65;-0.99], P &lt; 0.001), 3 months (MD: 1.19 [-2.14; −0.24], P = 0.014), 6 months (MD: 1.34 [-2.65; −0.04], P = 0.044), and 12 months (MD: 1.11 [-1.96;-0.26], P = 0.029), with the largest effect observed at 1 month. Disability improvements were significant at 1 month (standardized mean difference (SMD): 1.08 [-1.67; −0.48], P &lt; 0.001) and 3 months (SMD: 0.50 [-0.96; −0.04], P = 0.032), but not at 6 or 12 months. No significant differences were found in the risk for new vertebral compression fractures between both groups (odds ratio (OR): 1.36 [0.51; 3.64], P = 0.54). According to the GRADE system, moderate certainty evidence indicates that BKP provides superior pain relief compared to conservative treatment at all time points from 1 to 12 months.</div></div><div><h3>Conclusion</h3><div>BKP showed superior pain reduction compared to conservative treatment from 1 to 12 months and improved disability at 1 and 3 months, with moderate certainty evidence.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 1","pages":"Article 100569"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143629320","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":"Evaluation of fluoroscopically guided transforaminal epidural steroid injections for cervical radiculopathy utilizing patient reported outcome measurement information system as an outcome measure","authors":"Andrew R. Stephens,&nbsp;Ramzi El-Hassan,&nbsp;Ben L. Laplante,&nbsp;Rajeev K. Patel","doi":"10.1016/j.inpm.2025.100556","DOIUrl":"10.1016/j.inpm.2025.100556","url":null,"abstract":"<div><h3>Background</h3><div>Cervical radiculopathy is a common cause of pain. For patients who fail conservative management, a transforaminal epidural steroid injection (TFESI) is an accepted intervention and alternative to decompression surgery.</div></div><div><h3>Objective</h3><div>The purpose of this study was to evaluate the therapeutic effect of TFESIs for patients with cervical radiculopathy.</div></div><div><h3>Methods</h3><div>Adult patients treated at a multidisciplinary, tertiary academic spine center with cervical radicular pain and MRI evidence of corroborative cervical spondylotic foraminal stenosis and who had failed at least 6 weeks of conservative management consisting of medication and physical rehabilitation were included in this study. Patient Reported Outcome Measurement Information System (PROMIS) domains of Physical Function (PF) v1.2/v2.0 and Pain Interference (PI) v1.1 were collected at baseline and at 3-, 6-, and 12-month follow-up visits. Statistical analysis comparing baseline score with follow-up post-procedural PROMIS scores was performed. The percentage of patients who reported improvement exceeding the minimal clinically important difference was calculated for survey responders and for the worst case scenario.</div></div><div><h3>Results</h3><div>87 patients met inclusion criteria. PROMIS PI at 3-, 6-, and 12-months follow-up statistically improved by 2.2 (95 % confidence interval [CI] 2.1–2.4, p = 0.02), 2.3 (95 % CI 2.1–2.5, p = 0.03), and 2.7 (95 % CI 2.5–3.0, p = 0.03) points, respectively. Follow-up PROMIS PF score did not significantly differ from baseline scores. The percentage of patients that exceeded MCID thresholds of clinical significance was 59 % (95 % CI 47%–70 %) at 3-months, 52 % (95 % CI 41%–63 %) at 6-months, and 60 % (95 % CI 50%–72 %) at 12-months. Worst case scenario analysis demonstrated that 51 % (95 % CI 39%–62 %) of patients exceeded the MCID thresholds at 3-months, 32 % (95 % CI 22%–43 %) at 6-months, and 23 % (95 % CI 13%–33 %) at 12-months.</div></div><div><h3>Conclusions</h3><div>Our study demonstrated that TFESI leads to a long-term improvement up to a year in pain for patients with cervical radiculopathy.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 1","pages":"Article 100556"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520871","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":"Evaluating prognostic block selection criteria in cervical medial branch radiofrequency neurotomy: A retrospective cohort study","authors":"Allison Glinka Przybysz ,&nbsp;Enrique Galang ,&nbsp;Christian A. Sangio ,&nbsp;Christian Wirawan ,&nbsp;Amanda N. Cooper ,&nbsp;Alycia Amatto ,&nbsp;Brook Martin ,&nbsp;Robert Burnham ,&nbsp;Aaron M. Conger ,&nbsp;Zachary L. McCormick ,&nbsp;Taylor R. Burnham","doi":"10.1016/j.inpm.2025.100559","DOIUrl":"10.1016/j.inpm.2025.100559","url":null,"abstract":"<div><h3>Background</h3><div>Considerable variability exists in the literature record regarding patient selection criteria for cervical medial branch radiofrequency neurotomy (CMBRFN). Few prior studies have assessed the correlation between different prognostic block paradigms and treatment outcomes for this procedure.</div></div><div><h3>Objectives</h3><div>Examine the association between various prognostic block selection criteria and CMBRFN success rates.</div></div><div><h3>Methods</h3><div>Retrospective cohort study of consecutive patients from two Canadian musculoskeletal pain management clinics who underwent first-time CMBRFN between 2016 and 2022 with a three-tined cannula utilizing a perpendicular approach. Patients were categorized according to prognostic block paradigms (single vs. dual), block type (medial branch block [MBB] vs. intraarticular block [IAB]), and percentage pain relief after blocks. Six block criteria were established: 1 = MBB/MBB≥80 %; 2 = MBB/MBB 50–79 %; 3 = IAB/MBB≥80 %; 4 = IAB/MBB 50–79 %; 5 = MBB≥80 %; 6 = MBB 50–79 %. Treatment success was evaluated at 3 months post-CMBRFN as the proportion of participants with (1) ≥50 % NRS pain score reduction (the primary outcome) and (2) ≥17-point score decrease (the minimal clinically important difference [MCID]) on the Pain Disability Quality-of-Life Questionnaire – Spine (PDQQ-S). Logistic regression analyses were used to explore associations between block criteria and CMBRFN treatment success.</div></div><div><h3>Results</h3><div>A total of 171 consecutive patients (58.5 % female; 58.0 ± 12.1 years of age; BMI 28.7 ± 6.0 kg/m²) were included. 60.8 % (95%CI: 53.3–67.8 %) and 61.4 % (95%CI: 53.9–68.7 %) of patients reported ≥50 % NRS and ≥17-point PDQQ-S reduction, respectively. After controlling for demographic factors, there were no statistically significant differences in the odds of treatment success amongst individuals selected by various prognostic block paradigms.</div></div><div><h3>Conclusion</h3><div>Over 60 % of patients who underwent CMBRFN reported clinically significant magnitudes of improvement in pain and disability at three months post-CMBRFN, regardless of prognostic block selection criteria. These findings suggest that multiple block strategies might be employed to determine eligibility for CMBRFN. Larger, prospective studies including long-term outcome assessments are needed to further evaluate these findings.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 1","pages":"Article 100559"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683661","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}