Interventional Pain Medicine最新文献

{"title":"Spinal cord stimulation for Tarlov cyst-related pain: Initial success and subsequent explantation in an elderly patient","authors":"Alexandre J. Bourcier MD, MSc , Christina Im BA , Jane Phan BA , Michelle Nwufo MSc , Miad Hadaegh MD , Colton M. Malesovas MD , Jae Jung MD , Kyle Yang MD , Jonathan Droessler MD","doi":"10.1016/j.inpm.2025.100604","DOIUrl":"10.1016/j.inpm.2025.100604","url":null,"abstract":"","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 3","pages":"Article 100604"},"PeriodicalIF":0.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144335875","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":"What is the optimal block selection paradigm for predicting a successful treatment outcome following sacral lateral branch radiofrequency neurotomy? A real-world cohort study","authors":"Katharine A. Smolinski ,&nbsp;Christopher Radlicz ,&nbsp;Hasan Sen ,&nbsp;Amanda N. Cooper ,&nbsp;Brook Martin ,&nbsp;Alycia Amatto ,&nbsp;Allison Glinka Przybysz ,&nbsp;Robert Burnham ,&nbsp;Aaron M. Conger ,&nbsp;Zachary L. McCormick ,&nbsp;Taylor R. Burnham","doi":"10.1016/j.inpm.2025.100599","DOIUrl":"10.1016/j.inpm.2025.100599","url":null,"abstract":"<div><h3>Background</h3><div>Outcomes following sacral lateral branch radiofrequency neurotomy (SLBRFN) likely depend on patient selection criteria; however, commonly used criteria vary considerably. Refinement of selection criteria for SLBRFN may improve treatment outcomes. This study investigated common prognostic block-based selection criteria and treatment success following SLBRFN.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, consecutive patients from two Canadian musculoskeletal pain management clinics who underwent SLBRFN over a 6-year period (2016–2022) were identified by electronic medical record. Patients were categorized according to several prognostic block paradigms based on number of blocks (single vs. dual), block type (lateral branch block [LBB] vs. intra-articular block [IAB]), and subsequent percentage of pain relief. Six block criteria were established: 1 = LBB/LBB≥80 %; 2 = IAB/LBB≥80 %; 3 = LBB/LBB 50–79 %; 4 = IAB/LBB 50–79 %; 5 = LBB≥80 %; 6 = LBB 50–79 %. Treatment success was assessed at three months post-SLBRFN using two criteria: (1) the primary study outcome of ≥50 % numerical rating scale (NRS) pain reduction and (2) a secondary outcome of Pain Disability Quality-of-Life Questionnaire (PDQQ) score improvement by the minimal clinically important difference (MCID). Logistic regression analyses evaluated the association between block criteria and treatment success following SLBRFN.</div></div><div><h3>Results</h3><div>281 consecutive patients (75.1 % female, 61.8 ± 14.2 years of age, BMI 29.4 ± 6.6 kg/m²) were included. Cohort success rates for pain and functional improvement were 43.4 % (95 % CI: 37.8–49.3) and 46.6 % (95 % CI: 40.9–52.5), respectively. After adjusting for demographics and cannula type/SLBRFN technique, none of the odds ratios for the six prognostic block paradigms showed statistical significance.</div></div><div><h3>Conclusion</h3><div>Nearly 50 % of patients who underwent SLBRFN reported clinically significant improvement in pain and disability at three months post-procedure, regardless of prognostic block selection criteria. These results suggest that multiple block strategies may determine eligibility for SLBRFN.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100599"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189478","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":"Postamputation pain treatment by radiofrequency ablation of common peroneal nerve","authors":"David Majure ,&nbsp;Mark Shilling ,&nbsp;Janssen Puracan ,&nbsp;Eugene Koshkin ,&nbsp;Reza Ehsanian","doi":"10.1016/j.inpm.2025.100600","DOIUrl":"10.1016/j.inpm.2025.100600","url":null,"abstract":"","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100600"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222605","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":"Genicular nerve block with corticosteroid for chronic knee Pain: Patient-Reported outcomes across 9-years of practice","authors":"Mingda Chen ,&nbsp;Sercan Tosun ,&nbsp;Nicolas R. Thompson ,&nbsp;Kush K. Goyal","doi":"10.1016/j.inpm.2025.100601","DOIUrl":"10.1016/j.inpm.2025.100601","url":null,"abstract":"<div><h3>Background</h3><div>Genicular nerve blocks (GNB) for knee pain secondary to osteoarthritis (OA) are often performed with an anesthetic only, but corticosteroid can be used as an adjuvant with the goal of extending therapeutic relief. The efficacy of GNB with corticosteroid has been established in small, randomized trials, but its effectiveness in practice remains largely unknown.</div></div><div><h3>Objectives</h3><div>Evaluate the therapeutic effect of GNB with corticosteroid using patient-reported outcomes (PROs) in a large patient sample.</div></div><div><h3>Methods</h3><div>Data from consecutive GNBs with corticosteroid performed at an academic medical center from 2015 to 2024 was collected retrospectively. We included all patients aged ≥18 who received a GNB with corticosteroid for chronic knee pain due to OA, and excluded diagnostic GNBs with anesthetic alone and procedures performed using non-classical/modified techniques. Comparisons between pre-versus post-procedure PROs were by mixed-effect regression models with multiple testing corrections.</div></div><div><h3>Results</h3><div>A total of 123 GNBs (96 patients) with corticosteroid were identified. Post-procedurally, the mean NRS reductions were 3.56 (2–30 days), 2.14 (1–3 months), 1.92 (3–6 months), and 1.23 (6–12 months). 50 % of the patients maintained a pain reduction greater than or equal to the NRS MCID of −2.0 for at least 6.9 months. Post-procedure improvements in PROMIS-GH and PHQ9 were not clinically significant. Mean time to total knee arthroplasty was 16.5 months in 13.5 % of patients (13/96). For active opioid users, opioid usage was significantly decreased from the baseline 28.01 ± 13.20 MME/day to 13.58 ± 16.23 MME/day (p &lt; 0.002) in the first 6 months post-GNB, and this opioid reduction was maintained at 15.59 ± 12.51 MME/day (p &lt; 0.05) after the initial 6-month follow-up period.</div></div><div><h3>Conclusion</h3><div>For the majority of patients who received GNB with corticosteroid, we observed statistically and clinically significant pain reduction for 3 months or more in this cohort. While more comparative studies are required to evaluate its effectiveness, GNB with corticosteroid has promising potential as a safe and effective treatment for chronic knee pain.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100601"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184645","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":"Transsacrococcygeal ganglion impar block","authors":"Kelly Li ,&nbsp;David Hao","doi":"10.1016/j.inpm.2025.100595","DOIUrl":"10.1016/j.inpm.2025.100595","url":null,"abstract":"","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100595"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144239720","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":"Perspectives on treatment decision-making across racial groups in adults with degenerative lumbar disease – A pilot study","authors":"Emmy Duerr ,&nbsp;Emily Rodriguez ,&nbsp;Meron Nephtalem ,&nbsp;Emmanuel Mensah ,&nbsp;John R. Duffy ,&nbsp;Thomas Cha ,&nbsp;Jessica Aidlen ,&nbsp;Chadi Tannoury ,&nbsp;Michael D. Perloff ,&nbsp;Keren Ladin ,&nbsp;David Hao ,&nbsp;Theresa Williamson","doi":"10.1016/j.inpm.2025.100596","DOIUrl":"10.1016/j.inpm.2025.100596","url":null,"abstract":"<div><h3>Introduction</h3><div>Degenerative lumbar spine disease significantly impairs quality of life, yet racial and socioeconomic disparities in surgical treatment persist, particularly among BIPOC (Black, Indigenous, and Persons of Color) patients, who often experience worse outcomes and are less likely to undergo surgery despite similar or higher pain levels.</div></div><div><h3>Objectives</h3><div>This study explored factors that influence treatment decisions among BIPOC and Non-Hispanic White (NHW) patients with degenerative lumbar spine disease, with a focus on understanding how these factors may contribute to disparities in surgical care utilization.</div></div><div><h3>Methods</h3><div>An explorative qualitative study was conducted using semi-structured interviews with 20 patients (10 BIPOC, 10 NHW) considering lumbar spine surgery for spinal stenosis or disc herniation at three major academic institutions in Massachusetts. Thematic analysis identified key themes related to emotional suffering, financial concerns, support systems, and familiarity with spine surgery.</div></div><div><h3>Results</h3><div>BIPOC patients expressed greater anxiety about surgery, often shaped by prior negative healthcare experiences and broader systemic mistrust. Financial and occupational concerns were more significant for BIPOC patients, who frequently prioritized employment over symptom relief. In contrast, NHW patients more often cited quality-of-life goals as their primary motivator. While perception of support systems were comparable between the groups, emotional suffering was universally reported emotional suffering, with participants using terms such as “miserable,” “scared,” “embarrassed,” and “ashamed.”</div></div><div><h3>Conclusion</h3><div>Emotional, financial, and trust-related differences shape surgical decision-making among racially and ethnically diverse patients with lumbar spine disease. Incorporating culturally responsive communication strategies and decision aids that address patients fears, values, and social contexts may enhance shared decision-making and promote more equitable access to spine surgery.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100596"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144204894","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":"Biochemical reactions and ultrasound insights in percutaneous needle electrolysis therapy","authors":"Mustafa Turgut Yildizgoren ,&nbsp;Sema Nur Mutlu Ekici ,&nbsp;Burak Ekici","doi":"10.1016/j.inpm.2025.100593","DOIUrl":"10.1016/j.inpm.2025.100593","url":null,"abstract":"<div><div>Percutaneous needle electrolysis (PNE) applies low-voltage direct current to human tissue, inducing localized electrolysis. This process triggers controlled inflammation and promotes tissue repair. Hydrogen gas, a byproduct of electrolysis, appears as hyperechoic spots on ultrasound imaging, whereas other products such as sodium hydroxide and chlorine gas are less visible. PNE has demonstrated effectiveness in cases resistant to conventional therapies, including chronic lateral epicondylitis. Written informed consent were obtained from the patient.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100593"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194644","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":"Managing radicular pain in patients with normal MRIs: Challenges and insights?","authors":"David A. Provenzano ,&nbsp;Julie Pilitsis ,&nbsp;Christine Hunt","doi":"10.1016/j.inpm.2025.100591","DOIUrl":"10.1016/j.inpm.2025.100591","url":null,"abstract":"","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100591"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222608","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":"Decrease in opioid use and spinal interventions after basivertebral nerve ablation","authors":"Andrew R. Stephens,&nbsp;Adem F. Aktas,&nbsp;Ramzi El-Hassan","doi":"10.1016/j.inpm.2025.100594","DOIUrl":"10.1016/j.inpm.2025.100594","url":null,"abstract":"<div><h3>Background</h3><div>Basivertebral nerve radiofrequency ablations (BVNRFA) have shown efficacy in improving chronic back pain for indicated patients.</div></div><div><h3>Objective</h3><div>The purpose of this study was to evaluate health care utilization outcomes after BVNRFA in a large cohort utilizing a global database.</div></div><div><h3>Methods</h3><div>TriNetX, a global health research network, was queried from 2022 to 2025 for patients who underwent BVNRFA utilizing CPT codes and 1 year pre-procedure and post-procedure opioid use and spine interventions were recorded. Pre-procedure and post-procedure outcomes were compared using a chi-square test with significance set at p &lt; 0.05. The rate of spine surgery within 1 year after BVNRFA was also reported.</div></div><div><h3>Results</h3><div>A total of 1,118 patients underwent BVNRFA during this time frame at contributing health care systems with appropriate follow-up. Post-procedure opioid use was less than pre-procedure opioid use (57 % vs 51 %, p = 0.006). The number of patients who received spine interventions after BVNRFA were significantly lower compared to patients who received spine interventions prior with lumbar transforaminal epidural steroid injections decreasing from 21 % to 12 % (p &lt; 0.001), lumbar interlaminar steroid injections decreasing from 18 % to 11 % (p &lt; 0.001), and radiofrequency ablations decreasing from 25 % to 13 % (p &lt; 0.001). Only 47 patients had CPT codes related to post-procedure vertebral column spine surgery. Specifically, there were 11 patients who had CPT codes for posterior lumbar fusion (CPT 22630), 10 had lateral lumbar fusion (CPT 22533), and 10 had anterior codes (CPT 22558). There were 0 patients who underwent total disc replacement (CPT 22857).</div></div><div><h3>Conclusions</h3><div>This administrative database study demonstrated significantly less opioid use and spine interventions within 1 year after BVNRFA compared to 1 year prior. This study also demonstrated low rates of spine surgery within 1 year after BVNRFA.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100594"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144168849","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":"Effectiveness of epidural amniotic fluid injection for low back pain","authors":"Glenn R. Buttermann ,&nbsp;Matthew Thorson ,&nbsp;Louis C. Saeger","doi":"10.1016/j.inpm.2025.100598","DOIUrl":"10.1016/j.inpm.2025.100598","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Epidural corticosteroid injections have long been used to treat pain and inflammation associated with low back conditions including symptoms due to lumbar herniated disc, HNP; spinal stenosis, SS; and degenerative disc disease, DDD. Amniotic fluid, AF, is rich in the proteins and factors that are believed to contribute to healing by minimizing inflammation. AF injections in non-spinal conditions have been shown to be safe and avoid adverse effects related to steroids.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;To investigate the safety and efficacy of a single amniotic fluid injection into the lumbar epidural space for the treatment of low back pain. Specifically, this pilot study was to define indications for future large scale comparative studies.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This IRB approved prospective clinical study of 3 cohorts included 20 patients each with HNP, SS, and DDD with a 1-year follow-up. Patients were enrolled who had LBP ± leg symptoms for &gt;2 months, with clinical and MRI findings for HNP, SS, or DDD. Inclusion criteria necessitated that study patients had not responded to medications, physical therapy, and/or chiropractic. After obtaining consent, 20 patients in each diagnostic group (HNP, SS, and DDD) had 2 cc′s transforaminal epidural AF injected at the primary symptomatic level using fluoroscopy. Pre- and post-procedure outcomes measurements were obtained at follow-up periods of 2–3 weeks, 6–8 weeks, 3–4 months, 6–8 months and 1 year. Outcome measures were Visual Analog Scale (VAS) for back and leg pain, Oswestry Disability Scale (ODI), Patient-Reported Outcomes Measurement Information System (PROMIS) scores, and pain medication usage. Using the VAS and ODI measurements, Minimal Clinical Important Difference (MCID) and Success (50 % improvement) rates were derived.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The average age (years) of HNP, stenosis, and DDD patients was 46, 60, and 46 respectively. There were no complications or other adverse effects. HNP patients had the greatest reduction in symptoms with average LBP VAS improvement from 6.3 to 2.9, leg VAS from 5.9 to 2.2, ODI from 37 to 19, and PROMIS Physical component 13.1 to 14.7. SS patients had LBP VAS improvement from 6.8 to 5.3, leg VAS from 5.8 to 3.1, ODI from 46 to 33 and PROMIS Physical component 10.9 to 13.0. DDD patients had LBP VAS from 7.0 to 4.8, leg VAS from 3.9 to 2.7, ODI from 41 to 37 and PROMIS Physical component 12.0 to 13.1. HNP patients had a significant reduction in pain medication use. Over the one year follow-up, the HNP group had the greatest rate of attaining MCID (65 %–79 %) and Success (47 %–60 %). SS had a similar rate of Success for leg pain. ODI MCDI and Success rates were significantly greater for HNP vs the other 2 groups. Overall, 15 % of patients had additional injections and 20 % went on to surgery.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;AF epidural injections are most effective for patients with lu","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100598"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144168615","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}