Interventional Pain Medicine最新文献

{"title":"The effectiveness of thoracic medial branch radiofrequency neurotomy using a three-tined electrode: A single-arm, retrospective cohort study","authors":"Hasan Sen ,&nbsp;Amanda Cooper ,&nbsp;Andrew Stephens ,&nbsp;Brook Martin ,&nbsp;Robert S. Burnham ,&nbsp;Aaron Conger ,&nbsp;Zachary L. McCormick ,&nbsp;Taylor R. Burnham","doi":"10.1016/j.inpm.2025.100563","DOIUrl":"10.1016/j.inpm.2025.100563","url":null,"abstract":"<div><h3>Background</h3><div>Thoracic medial branch radiofrequency neurotomy (TMBRFN) is used to treat chronic thoracic facet joint pain, but research on its technique and effectiveness is still needed. The current International Pain and Spine Intervention Society Practice Guidelines do not describe a technique for TMBRFN.</div></div><div><h3>Objectives</h3><div>Evaluate the effectiveness of TMBRFN in patients with thoracic facet joint pain.</div></div><div><h3>Methods</h3><div>Single-arm, retrospective cohort study of consecutive patients from two Canadian musculoskeletal pain management clinics who underwent first-time TMBRFN between 2016 and 2022. The primary outcome was the proportion of patients with ≥50 % reduction in numerical rating scale (NRS) pain score at 3-months post-procedure. Secondary outcomes included the proportion of patients who achieved a ≥17-point reduction on the Pain Disability Quality-Of-Life Questionnaire-Spine (PDQQ-S) at 3-months, as well as mean patient-reported percentage pain relief and duration of relief after a successful index TMBRFN in individuals who reported a return of their index symptoms.</div></div><div><h3>Results</h3><div>18 consecutive patients (50.0 % male; mean age 60.9 ± 15.3 years; mean BMI 30.3 ± 6.9 kg/m²) were analyzed. At 3 months post-procedure, 10 patients (55.6 % [95%CI 33.7–75.4]) reported ≥50 % NRS pain reduction and 9 (50.0 % [95%CI 29.0–71.0]) reported ≥17-point PDQQ-S reduction. Of the 10 patients with successful treatment responses, 4 had a return of symptoms after an average of 9.3 ± 2.2 months with a reported retrospective mean percentage pain relief of 70.0 ± 34.6 %.</div></div><div><h3>Conclusion</h3><div>Within this cohort, approximately 60 % of patients experienced improvement in pain and disability at 3 months following TMBRFN. Among patients whose index symptoms returned after successful treatment, the average reported pain relief was 70 % for close to 9 months. Larger, prospective studies with long-term outcomes are needed to better elucidate the safety and effectiveness of TMBRFN.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 1","pages":"Article 100563"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520853","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":"Editorial review of qualitative and quantitative characteristics of the lumbar multifidus muscles: Comparison of the magnetic resonance imaging and musculoskeletal ultrasound","authors":"Lynn Kohan","doi":"10.1016/j.inpm.2025.100555","DOIUrl":"10.1016/j.inpm.2025.100555","url":null,"abstract":"","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 1","pages":"Article 100555"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety practices for interventional pain procedures: Facet interventions","authors":"Stephan Klessinger ,&nbsp;Nathaniel Schuster ,&nbsp;John MacVicar ,&nbsp;David C. Miller ,&nbsp;Michael McKenna ,&nbsp;Yakov Vorobeychik ,&nbsp;Adrian Popescu ,&nbsp;Zachary L. McCormick ,&nbsp;Lisa Doan ,&nbsp;Johan Hambraues ,&nbsp;Patrick H. Waring ,&nbsp;Zirong Zhao ,&nbsp;Brian Boies ,&nbsp;Ameet Nagpal ,&nbsp;International Pain and Spine Intervention Society","doi":"10.1016/j.inpm.2025.100549","DOIUrl":"10.1016/j.inpm.2025.100549","url":null,"abstract":"","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 1","pages":"Article 100549"},"PeriodicalIF":0.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143487945","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 phases of transition from fluoroscopy to ultrasound-guided pain medicine interventions","authors":"Swapnil Kumar Barasker ,&nbsp;Nisha Modi ,&nbsp;Anshul Agrawal","doi":"10.1016/j.inpm.2025.100554","DOIUrl":"10.1016/j.inpm.2025.100554","url":null,"abstract":"<div><div>Ultrasonography (USG)-guided interventions have transformed pain medicine by enhancing precision, efficacy, and safety through real-time anatomical visualization. Despite these advantages, mastering USG techniques presents a steep learning curve, especially for practitioners transitioning from fluoroscopy-guided methods. Adapting the Transtheoretical Model of Behavior Change, this commentary outlines a five-phase framework for transitioning to USG-guided pain medicine interventions: overcoming initial reluctance, addressing sonoanatomy challenges, improving probe stabilization, needle visualization, and achieving expertise. Each stage reflects progressive skill acquisition, highlighting structured training and mentorship as critical facilitators. This phased approach may accelerate learning and fosters proficiency, improving clinical outcomes in pain medicine interventionsinterventions.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 1","pages":"Article 100554"},"PeriodicalIF":0.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143445676","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":"Optimizing patient understanding of spine MRI reports using AI: A prospective single center study","authors":"Sebastian Encalada ,&nbsp;Sahil Gupta ,&nbsp;Christine Hunt ,&nbsp;Jason Eldrige ,&nbsp;John Evans II ,&nbsp;Johanna Mosquera-Moscoso ,&nbsp;Laura Furtado Pessoa de Mendonca ,&nbsp;Sharima Kanahan-Osman ,&nbsp;Sohail Bade ,&nbsp;Sahil Bade ,&nbsp;Lisbet Ivicic ,&nbsp;Stephanie Foskey ,&nbsp;Jason Lyles ,&nbsp;Juan Suarez ,&nbsp;Aaron Fisher ,&nbsp;Hamaad Khan ,&nbsp;Jeffrey A. Stone ,&nbsp;Mark Hurdle","doi":"10.1016/j.inpm.2025.100550","DOIUrl":"10.1016/j.inpm.2025.100550","url":null,"abstract":"<div><h3>Background</h3><div>Patient comprehension of spine MRI reports remains a significant challenge, potentially affecting healthcare engagement and outcomes. Artificial Intelligence (AI) may offer a solution for interpreting complex medical terminology into layman's terms language.</div></div><div><h3>Objective</h3><div>To evaluate the effectiveness of AI-based interpretation of spine MRI reports in improving patient comprehension and satisfaction.</div></div><div><h3>Methods</h3><div>A prospective, single-center survey study was conducted at a single institution's multidisciplinary pain and spine clinics from May 2024 to November 2024, enrolling 102 adult patients scheduled for spine MRI. Imaging reports were interpreted using a single AI-based Large Language Model (LLM) that is securely operated within the hospital's network, with interpretations independently reviewed by healthcare providers and research coordinators. A board-certified neuroradiologist evaluated the accuracy of AI interpretations using a standardized 5-point scale. We analyzed survey responses from participants who received both their original MRI reports and AI-interpreted versions, comparing comprehension, clarity, engagement, and satisfaction.</div></div><div><h3>Results</h3><div>Participants reported higher comprehension with AI-interpreted MRI reports versus original radiology reports (8.50 ± 1.91 vs 6.56 ± 2.42; P &lt; .001). AI interpretations received superior scores for clarity (8.57 ± 1.79 vs 6.96 ± 2.12; P &lt; .001), understanding of medical conditions (7.75 ± 2.18 vs 6.27 ± 2.28; P &lt; .001), and healthcare engagement (8.35 ± 2.00 vs 6.78 ± 2.48; P &lt; .001). Accuracy assessment showed that 82.4 % of AI interpretations achieved high-quality ratings (≥4) [95 % CI: 69.7%–90.4 %], while 92.2 % were rated acceptable (≥3). Most participants (54.0 %) assigned the highest possible recommendation scores to AI interpretation. No significant differences were found between age groups and gender.</div></div><div><h3>Conclusions</h3><div>AI-based interpretation of spine MRI reports significantly improved patient comprehension and satisfaction. Despite the promise of rapidly evolving AI-based technologies, a considerable percentage of AI interpretations were deemed to be inaccurate, warranting the need for further research.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 1","pages":"Article 100550"},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437734","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":"Strategies for combining interventional and behavioral therapies in management of chronic low back pain: A scoping review","authors":"Jasmina Solankee ,&nbsp;Royce Sumayo ,&nbsp;Thiru M. Annaswamy","doi":"10.1016/j.inpm.2025.100551","DOIUrl":"10.1016/j.inpm.2025.100551","url":null,"abstract":"<div><h3>Background</h3><div>Common non-surgical treatment approaches for chronic low back pain (CLBP) include pharmacologic, interventional and behavioral therapies, but there is no consensus treatment approach. Despite studies that show the effectiveness of interventional and behavioral approaches individually and evidence-based recommendations for multimodal treatment approach, specific stacking and sequencing strategies used to combine both approaches haven't been studied.</div></div><div><h3>Objectives</h3><div>The objectives of this scoping review were to: 1) explore how interventional and behavioral approaches to CLBP treatment are stacked or sequenced; 2) evaluate the feasibility of utilizing interventional and behavioral treatments in an integrative manner, and 3) assess whether optimal combinations of interventional and behavioral approaches to CLBP treatment exist.</div></div><div><h3>Methods</h3><div>A literature search of indexed and gray literature was conducted for studies involving the combination of interventional and behavioral therapies for treatment of CLBP. 374 abstracts and 72 records of gray literature were independently screened followed by 60 that underwent full-text review.</div></div><div><h3>Results</h3><div>A total of three studies were included in this review, all of which found the integration of modalities to be feasible. Two studies that utilized non-conventional interventions found no significant treatment effect by combining modalities. One study demonstrated a non-significant additive effect of combining radiofrequency ablation with cognitive behavioral therapy.</div></div><div><h3>Conclusions</h3><div>Despite known individual benefits, there are limited studies exploring combined interventional and behavioral approaches to CLBP. Given the feasibility and the additive effects of combining interventions with behavioral therapy seen in the studies included this review, further exploration of this subject is needed to guide clinical practice.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 1","pages":"Article 100551"},"PeriodicalIF":0.0,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143421259","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":"Rare presentation of Pseudomonas aeruginosa meningitis following intrathecal pump replacement","authors":"Cyrus Ghaffari,&nbsp;Rajiv Reddy,&nbsp;Tim Furnish","doi":"10.1016/j.inpm.2025.100548","DOIUrl":"10.1016/j.inpm.2025.100548","url":null,"abstract":"","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 1","pages":"Article 100548"},"PeriodicalIF":0.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395453","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":"Qualitative and quantitative characteristics of the lumbar multifidi muscles: Comparison of the magnetic resonance imaging and musculoskeletal ultrasound","authors":"Michael Gofeld ,&nbsp;Aditya Bharatha","doi":"10.1016/j.inpm.2025.100547","DOIUrl":"10.1016/j.inpm.2025.100547","url":null,"abstract":"<div><h3>Background</h3><div>Paraspinal muscle pathology is often accompanied by skeletal abnormalities and is frequently associated with low back pain. While magnetic resonance imaging (MRI) can accurately assess muscle atrophy, the utility of musculoskeletal ultrasound remains under evaluation. A direct comparison between these imaging modalities has not been conducted.</div></div><div><h3>Objective</h3><div>To compare musculoskeletal ultrasound and MRI in evaluating fatty atrophy and cross-sectional area in patients with chronic low back pain and to assess their correlations with clinical symptoms.</div></div><div><h3>Methods</h3><div>The degree of fatty atrophy and cross-sectional area were measured using ultrasound at symptomatic and control levels in patients with chronic low back pain. A prone instability test was also performed. Ultrasound findings were compared with recent lumbar MRI results. Fatty atrophy was graded using the Kjaer system, and cross-sectional area was measured. Interobserver agreement and correlation with the available imaging were calculated.</div></div><div><h3>Results</h3><div>Strong agreement was observed with MRI for the degree of atrophy at the symptomatic level (weighted Kappa = 0.83), but only fair agreement at the control level. Cross-sectional measurements showed poor correlation between the imaging studies at both levels (Rho = 0.03–0.07). The prone instability test was negative for all participants.</div></div><div><h3>Conclusion</h3><div>Ultrasound reliably assesses fatty atrophy at symptomatic levels but is less accurate for circumferential measurements.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 1","pages":"Article 100547"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387831","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":"Peripheral superior cluneal nerve stimulation for intractable low back pain: Combined fluoroscopy and ultrasound technique, A case series","authors":"Nicolas M. Mas D Alessandro ,&nbsp;Faria Nisar ,&nbsp;Hesham Elsharkawy","doi":"10.1016/j.inpm.2025.100542","DOIUrl":"10.1016/j.inpm.2025.100542","url":null,"abstract":"<div><h3>Background</h3><div>Chronic low back pain (CLBP) is a common and debilitating condition often difficult to diagnose, with entrapment of the superior cluneal nerves (SCN) being a overlooked cause. Cluneal neuralgia (CN) arises from injury to the SCN and can significantly impact patients' quality of life.</div></div><div><h3>Objectives</h3><div>This case series aims to evaluate the effectiveness of the Micro Lead - SPRINT Peripheral Nerve Stimulation (PNS) System, (Cleveland, Ohio, USA) for treating cluneal neuralgia, utilizing both fluoroscopic and ultrasound guidance for accurate nerve localization.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted on six nonconsecutive patients who underwent Micro Lead - SPRINT Peripheral Nerve Stimulation (PNS) System, (Cleveland, Ohio, USA) implantation for cluneal nerve entrapment at MetroHealth System between August 2021 and January 2024. Patient selection focused on individuals with cluneal neuralgia refractory to conservative treatments. Data collection included demographics, pain characteristics, opioid usage, and follow-up evaluations at 30, 60, 90 days, and 2 years post-procedure. Outcomes were assessed using the Numerical Rating Scale (NRS) for pain. Dividing the NRS score by the maximum score (10) and multiplying by 100 expresses pain intensity as a percentage.</div></div><div><h3>Results</h3><div>Among the six nonconsecutive patients (83 % female, mean age 60 years), the mean pain score prior to implantation was 7.1. At follow-up, five patients reported over 50 % improvement in pain and functional status. Three patients with prior opioid use had varying outcomes regarding opioid consumption post-procedure.</div></div><div><h3>Conclusion</h3><div>The Micro Lead - SPRINT Peripheral Nerve Stimulation (PNS) System, (Cleveland, Ohio, USA) demonstrates promise as an effective treatment for cluneal neuralgia, leading to reductions in pain and improvements in daily living activities. Further studies are warranted to validate these findings.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 1","pages":"Article 100542"},"PeriodicalIF":0.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143220265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel single-lead percutaneous approach for multi-nerve peripheral stimulation in upper extremity pain: A case report","authors":"Ryan S. D'Souza ,&nbsp;Nasir Hussain","doi":"10.1016/j.inpm.2025.100546","DOIUrl":"10.1016/j.inpm.2025.100546","url":null,"abstract":"<div><div>Peripheral nerve stimulation (PNS) is an emerging modality for managing painful peripheral neuropathy, offering potential long-term relief when conservative treatments fall short. Conventionally, each PNS lead targets a single nerve, necessitating multiple leads in cases involving pain across multiple nerve distributions. This case report presents a novel approach using a single PNS lead to target multiple peripheral nerves in the upper extremity via an axillary brachial plexus approach. We describe a 47-year-old female with a three-year history of intractable neuropathic pain localized to the ulnar and median nerve distributions, who underwent a temporary PNS trial after failing conventional therapies, including physical therapy, medications, and corticosteroid injections. Under ultrasound guidance, a single PNS lead was placed at the brachial plexus, targeting both ulnar and median nerves. Optimal stimulation thresholds were achieved, and the patient reported 80–100% pain relief throughout the 60-day trial period, with sustained relief for six months post-lead removal. This approach leverages the anatomical proximity of the ulnar, median, and radial nerves at the axilla, enabling multi-nerve targeting with a single lead. The technique offers potential advantages, including reduced procedural complexity, fewer risks, and cost savings, especially in the current landscape of increasing insurance denials for neuromodulation procedures.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 1","pages":"Article 100546"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143133275","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}