Interventional Pain Medicine最新文献

{"title":"Herpes zoster prevalence following epidural steroid injections: a retrospective review","authors":"Laura Furtado-Pessoa-de-Mendonca ,&nbsp;Sebastian Encalada ,&nbsp;Alejandro Hallo-Carrasco ,&nbsp;Johanna Mosquera-Moscoso ,&nbsp;Matthew A. Cascio ,&nbsp;Robert Pagan-Rosado ,&nbsp;Michael D. Osborne ,&nbsp;Jason S. Eldrige ,&nbsp;Christine L. Hunt","doi":"10.1016/j.inpm.2025.100597","DOIUrl":"10.1016/j.inpm.2025.100597","url":null,"abstract":"<div><h3>Introduction</h3><div>Herpes Zoster, or shingles, is an infection caused by the reactivation of the latent Varicella zoster virus within a sensory ganglion, leading to painful skin lesions localized along dermatomes. Patients undergoing pain medicine procedures involving steroids may face an elevated risk of shingles, which can significantly impact their quality of life. Though rare, HZ has been reported following minimally invasive procedures, such as epidural steroid injections.</div></div><div><h3>Objectives</h3><div>We evaluated the prevalence of shingles within 31 days after epidural steroid injections within Mayo Enterprise sites.</div></div><div><h3>Methods</h3><div>A retrospective chart review included all patients who reported a new HZ event within 31 days after receiving an epidural steroid injection. Information on patient demographics, procedure details, and potential risk factors for herpes zoster was assessed using qualitative analysis.</div></div><div><h3>Results</h3><div>A total of 50,270 epidural injections were performed during the analyzed period. After initial screening, 149 patients were included for chart review, and 37 individuals met the inclusion criteria. Within this subgroup, the median age was 72, and 21 patients were female (56.76 %). The mean timeframe from the procedure until onset of symptoms of infection as reported in the medical record was 15.9 days. Among the patients in the study, 24 patients (64.86 %) had an identified immunocompromised status, and 28 (75.68 %) had an incomplete vaccination status at the time of infection.</div></div><div><h3>Conclusion</h3><div>The incidence of HZ following ESI is low. Other risk factors linked to HZ were identified in our cohort, confounding a possible causal relationship. Prospective studies are needed to elucidate any relationship between ESI and HZ.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100597"},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169035","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":"Assessing ChatGPT responses to patient questions on epidural steroid injections: A comparative study of general vs specific queries","authors":"Timothy Olivier ,&nbsp;Zilin Ma ,&nbsp;Ankit Patel ,&nbsp;Weibin Shi ,&nbsp;Mohammed Murtuza ,&nbsp;Nicole E. Hatchard ,&nbsp;Xiaoyu Norman Pan ,&nbsp;Thiru M. Annaswamy","doi":"10.1016/j.inpm.2025.100592","DOIUrl":"10.1016/j.inpm.2025.100592","url":null,"abstract":"<div><h3>Background</h3><div>Artificial intelligence (AI) is becoming more integrated into healthcare, with large language models (LLMs) like ChatGPT being widely used by patients to answer medical questions. Given the increasing reliance on AI for health-related information, it's important to evaluate how well these models perform in addressing common patient concerns, especially in procedural medicine. To date, no studies have specifically examined AI's role in addressing patient questions related to epidural steroid injections (ESIs), making this an important area for investigation.</div></div><div><h3>Objective</h3><div>This study examines ChatGPT's ability to answer patient questions about epidural steroid injections (ESIs), focusing on response accuracy, readability, and overall usefulness. Our aim was to evaluate and compare the content, accuracy, and user-friendliness of AI-generated information on common peri-procedural questions and complications associated with ESIs, thereby extending the application of AI as a triage tool into pain management and interventional spine procedures.</div></div><div><h3>Methods</h3><div>We formulated and compiled 29 common patient questions about ESIs and tested ChatGPT's responses in both general and specific formats. Two interventional pain specialists reviewed the AI-generated answers, assessing them for accuracy, clarity, empathy, and directness using a Likert scale. Readability scores were calculated using Flesch-Kincaid Reading Level and Flesch Reading Ease scales. Statistical analyses were performed to compare general versus specific responses.</div></div><div><h3>Results</h3><div>General queries led to longer, more detailed responses, but readability was similar between general and specific formats. Subjective analysis showed that general responses were rated higher for accuracy, clarity, and responsiveness. However, neither format demonstrated strong empathy, and some general queries resulted in off-topic responses, underscoring the importance of precise wording when interacting with AI.</div></div><div><h3>Conclusion</h3><div>ChatGPT can provide clear and largely accurate answers to patient questions about ESIs, with general prompts often producing more complete responses. However, AI-generated content still has limitations, particularly in conveying empathy and avoiding tangential information. These findings highlight the need for thoughtful prompt design and further research into how AI can be integrated into clinical workflows while ensuring accuracy and patient safety.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100592"},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134973","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 effectiveness of fluoroscopically guided lumbar facet steroid joint injections: A systematic review","authors":"Alexandra E. Fogarty ,&nbsp;Jordan A. Buttner ,&nbsp;Belinda Duszynski ,&nbsp;Michael J. McKenna ,&nbsp;David C. Miller ,&nbsp;Alan Gonzalez-Cota ,&nbsp;Arsenio Avila ,&nbsp;Eduard Vaynberg ,&nbsp;Samir Sheth ,&nbsp;Aaron Conger ,&nbsp;Lisa V. Doan ,&nbsp;Reza Ehsanian","doi":"10.1016/j.inpm.2025.100587","DOIUrl":"10.1016/j.inpm.2025.100587","url":null,"abstract":"<div><h3>Summary of background data</h3><div>Facet joint degeneration is a known source of chronic axial low back pain, and intra-articular steroid injections (IASI) have been used as a treatment.</div></div><div><h3>Objectives</h3><div>To systematically review the evidence of the effectiveness of fluoroscopically guided lumbar IASI for the treatment of lumbar facet joint pain.</div></div><div><h3>Methods</h3><div>The primary outcome was ≥50 % pain reduction at ≥ 1 month, measured by Visual Analog Scale and/or Numeric Rating Scale. Secondary outcomes included ≥30 % functional improvement on a validated functional scale. Studies including group mean improvements in pain/function without categorical reporting were also considered. Two reviewers independently screened Embase, Cochrane, PubMed Medline, Ovid Medline, Web of Knowledge, and Google Scholar. The risk of bias was assessed using the Cochrane Risk of Bias Tool, and evidence quality was evaluated using Grades of Recommendation, Assessment, Development, and Evaluation (GRADE).</div></div><div><h3>Results</h3><div>Of the 701 publications screened, 21 met the inclusion criteria. Success rates for clinically significant pain reduction (≥50 % pain relief) ranged from 13 to 74 %, and functional improvement (≥30 % improvement) was 29 % at ≥ 1 month, based on only one study. Overall, mean improvement ranged from 11 to 59 % for pain relief and 8–58 % for function at ≥ 1 month. In the seven studies selecting patients with facet or medial branch blocks, success rates for clinically significant pain reduction (≥50 % pain relief) are reported as 13–74 % at ≥ 1 month. In this subgroup, mean pain improvement rates ranged from 23 to 67 % and functional improvement from 15 to 58 % at ≥ 1 month. According to GRADE, the overall quality of the evidence is very low due to the high risk of bias, study heterogeneity, and inconsistent methodologies.</div></div><div><h3>Discussion/conclusion</h3><div>Pragmatic and observational studies suggest IASI may reduce pain and disability, while sham-controlled trials have not demonstrated efficacy. Given the very low quality of evidence, the true effect of IASI is highly uncertain. Further high-quality, placebo-controlled studies using standardized diagnostic criteria are needed.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100587"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143922509","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":"Pericapsular Nerve Group (PENG) Block in Three Simple Steps: A Practical Note for Physiatrists on Interfascial Injection","authors":"Mustafa Turgut Yildizgoren ,&nbsp;Burak Tayyip Dede ,&nbsp;Bulent Alyanak ,&nbsp;Mustafa Huseyin Temel ,&nbsp;Fatih Bagcier","doi":"10.1016/j.inpm.2025.100589","DOIUrl":"10.1016/j.inpm.2025.100589","url":null,"abstract":"","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100589"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143922512","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":"Evidence of non-response bias in patient reported outcome measurement information system surveys","authors":"Andrew R. Stephens,&nbsp;Nicholas R. Bender,&nbsp;Ramzi El-Hassan,&nbsp;Rajeev K. Patel","doi":"10.1016/j.inpm.2025.100588","DOIUrl":"10.1016/j.inpm.2025.100588","url":null,"abstract":"<div><h3>Background</h3><div>Patient-reported outcome measurement instrument surveys (PROMIS) have been increasingly used to assess clinical outcomes following a variety of medical procedures. Despite their value in evaluating patient functional status, response rates to these surveys remain low. Understanding differences in demographics between responders and non-responders to PROMIS may be beneficial to improving generalizability and response rates.</div></div><div><h3>Objective</h3><div>The primary aim of this study was to compare demographic characteristics between patients who respond to PROMIS surveys and those who do not, hypothesizing no significant differences between these groups.</div></div><div><h3>Methods</h3><div>Adult new patient visits from 2018 to 2022 in Department of Physical Medicine &amp; Rehabilitation outpatient clinics at a single academic medical center were analyzed. Patients completed PROMIS surveys (physical function, pain interference, and depression) on iPads at each clinic visit. Demographic variables such as gender, race, BMI, smoking status, employment status, marital status, and Area Deprivation Index (ADI) were collected. Univariate and multivariate analyses were conducted to assess for variables associated with an increased likelihood of responding to PROMIS surveys.</div></div><div><h3>Results</h3><div>A total of 29,830 patients were included in this study. Of the total patient cohort, 8331 (27.9 %) responded to the PROMIS surveys. Significant demographic differences were found between responders and non-responders. Patients in the least deprived ADI quartile were more likely to respond compared to those in the most deprived quartile (33.5 % vs 23.7 %, p &lt; 0.001). Employed patients, white patients, non-smokers and married individuals were more likely to respond. On multivariate analysis, unemployment (OR 0.71, p = 0.006), increased BMI (OR 0.93, p = 0.014), and higher ADI (OR 0.94, p = 0.003) were significantly associated with lower response rates.</div></div><div><h3>Conclusions</h3><div>PROMIS response rates are influenced by patient demographics, with lower response rates observed in unemployed, non-white, and socioeconomically deprived populations. These findings highlight the need for targeted interventions to increase response rates and ensure equitable data collection in PROMIS surveys to enhancing the generalizability of clinical decisions made using PROMIS data.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100588"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143929288","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 epidural steroid injections for lumbosacral radicular pain in patients with normal imaging: A propensity-matched study","authors":"Steven P. Cohen ,&nbsp;Ariz A. Keshwani ,&nbsp;Dost Khan ,&nbsp;Milan P. Stojanovic","doi":"10.1016/j.inpm.2025.100574","DOIUrl":"10.1016/j.inpm.2025.100574","url":null,"abstract":"<div><h3>Background</h3><div>Epidural steroid injections are indicated for radicular pain, with a pre-injection MRI not mandated in guidelines. There is conflicting evidence that MRI findings correlate with outcomes.</div></div><div><h3>Methods</h3><div>Fourteen patients with near-normal imaging (i.e., no evidence of nerve root compression and minor degenerative changes if present) who underwent ESI for lumbosacral radicular pain and were followed for up to 12 weeks were propensity matched against 14 patients with radicular pain secondary to concordant MRI pathology. The primary outcome measure was mean reduction in average leg pain relief at 4 and 12 weeks. Secondary outcome measures included average back pain, function, analgesic reduction, satisfaction, and a categorical measure of success predesignated as a ≥2-point decrease in average leg pain score coupled with a positive global perceived effect and not requiring any additional intervening interventions.</div></div><div><h3>Results</h3><div>For mean reduction in average leg pain at 4 weeks, there were no significant differences between those with near-normal MRIs and those with abnormal imaging (2.36 (SD 2.55) vs. 2.61 (SD 2.15); P = 0.72). For average back pain reduction at the same time point, the mean reduction was 0.75 (1.73) among cases vs. 1.07 (2.01) in control patients (P = 0.57). There were also no differences observed in pain reduction outcomes at 12 weeks. The average reduction in Oswestry Disability Index at 12 weeks favored the near-normal imaging group (8.64 % (SD 11.36) vs. 0 % (7.69); P = 0.047). A trend was noted wherein more patients with abnormal imaging experienced a positive outcome at 4 weeks (50 % vs. 28.57 %; P = 0.22) but not 12 weeks (28.57 % in both groups).</div></div><div><h3>Conclusions</h3><div>There were no significant differences in pain outcomes compared to control patients, though patients with near-normal imaging fared worse than historical controls and the larger cohort from which propensity-matched patients were selected. The possibility of poorer outcomes should be considered when selecting patients with normal imaging and radiculopathy for ESI.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100574"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143929287","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":"Tendon modification with percutaneous Ultrasound-Guided Tenotomy using TENEX®: A histological and macroscopic analysis of a bovine cadaveric model","authors":"Suwannika Palee ,&nbsp;Chuanyong Lu ,&nbsp;Adam Betcher ,&nbsp;Ugur Yener ,&nbsp;Jonathan Alerte ,&nbsp;David Howarth ,&nbsp;Luke Cooper ,&nbsp;Asude Nur Hasanoglu ,&nbsp;Alaa Abd-Elsayed ,&nbsp;Sayed Emal Wahezi","doi":"10.1016/j.inpm.2025.100590","DOIUrl":"10.1016/j.inpm.2025.100590","url":null,"abstract":"<div><h3>Background</h3><div>Chronic tendinopathy treatment remains elusive; however, percutaneous Ultrasound-Guided Tenotomy using TENEX® (PUTT) has demonstrated promising clinical outcomes, but the mechanism of action is not clearly defined. This study aims to describe potential mechanisms using an ex-vivo animal model. The objective of the study is to examine the histological effects of PUTT on the bovine soleus tendon across varying treatment durations.</div></div><div><h3>Methods</h3><div>Twelve bovine soleus tendons were allocated to four cohorts to undergo PUTT for 1, 3, 5, and 7 min. Each specimen was treated on one side, the opposite side serving as a control. Macroscopic and microscopic analyses were conducted to assess tendon sheath, fascicle, and perineural disruption. Fascicle penetration was measured using ImageJ software. Statistical analyses were performed using Analysis of Variance (ANOVA), with significance levels set at p &lt; 0.05.</div></div><div><h3>Results</h3><div>Macroscopic and microscopic examination revealed progressive separation of the paratenon, peritendinous nerves, and fascicles, correlating with increased treatment duration. Fascicle penetration depths were 0.1 mm, 2.57 mm, 2.61 mm, and 3.93 mm at 1, 3, 5, and 7 min, respectively. ANOVA confirmed significant differences among groups (F (3, 8) = 620.898, p &lt; 0.001), with a large effect size (η² = 0.996. Tukey's Honest Significant Difference (HSD) test revealed significant differences between most groups (p &lt; 0.001), except between the 3-min and 5-min treatments, which showed no significant difference (p = 0.969).</div></div><div><h3>Conclusion</h3><div>PUTT induces significant structural changes in the paratenon and fascicle layer with longer treatment duration, resulting in more pronounced modifications.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100590"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143922511","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 paravertebral block in patients with herpes zoster according to the contrast spreading pattern: a retrospective cohort study","authors":"Woojin Kwon ,&nbsp;Junho Kim ,&nbsp;Somin Ahn ,&nbsp;Chi-Bum In","doi":"10.1016/j.inpm.2025.100585","DOIUrl":"10.1016/j.inpm.2025.100585","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to evaluate the treatment response to thoracic paravertebral block (PVB) in thoracic herpes zoster (HZ) pain based on the contrast spreading pattern.</div></div><div><h3>Methods</h3><div>Patients with HZ pain who underwent thoracic PVB under fluoroscopy were retrospectively analyzed. A comparative analysis of the treatment response was conducted between patients with epidural spread (ES group) and those without epidural spread (NES group) at the first visit after PVB. The treatment response was determined by setting the minimum clinically important difference (MCID) as a reduction of more than 1 point on the pain numerical rating scale (NRS). In addition, the treatment responses were compared according to prevertebral spread, intercostal spread, and segmented medial spread (base, foraminal, and subarticular-central spread). The NRS score was assessed at baseline and 3 days, 2 weeks, 1 and month after PVB. Generalized estimating equation (GEE) analysis was performed to identify the factors associated with the treatment response over time.</div></div><div><h3>Results</h3><div>In total, 48 patients were enrolled (ES, n = 21; NES, n = 27). The ES group had a higher proportion of patients with the treatment response than the NES group (<em>p</em> = 0.025). However, there was no significant difference in the treatment response according to prevertebral, intercostal, and segmented medial spread. In both groups, the mean NRS scores significantly decreased over time. Comparisons between groups at each time point were not significantly different. The GEE analysis showed that the duration after rash onset was the only significantly related factor in treatment response.</div></div><div><h3>Conclusions</h3><div>Patients with HZ pain who had epidural spread in PVB showed a better treatment response than those who did not at the first post-PVB assessment. Other spreading patterns did not have a significant effect on the treatment response. NRS decreased over time with no differences between groups. Only the duration after rash onset affected the longitudinal treatment response. Additional research is required to verify the efficacy of epidural spread in PVB.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 2","pages":"Article 100585"},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143879085","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":"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}