Interventional Pain Medicine最新文献

{"title":"Ultrasound-guided perineural intercostal autologous platelet-rich plasma in the treatment of chronic post-thoracotomy pain syndrome – A prospective case series","authors":"César Gracia-Fabre ,&nbsp;Tomas Cuñat ,&nbsp;Eduardo Matos-Ribeiro ,&nbsp;Rosario Armand-Ugon ,&nbsp;Guilherme Ferreira-Dos-Santos","doi":"10.1016/j.inpm.2024.100448","DOIUrl":"10.1016/j.inpm.2024.100448","url":null,"abstract":"<div><h3>Background</h3><div>Post-thoracotomy pain syndrome poses a significant challenge in clinical management due to its debilitating nature. Current treatment strategies often involve multimodal approaches, including pharmacology and interventional procedures. Recently, platelet-rich plasma has emerged as a potential therapeutic option for chronic neuropathic pain, yet its efficacy in post-thoracotomy pain syndrome remains unexplored.</div></div><div><h3>Methods</h3><div>This prospective consecutive case series aimed to evaluate the effectiveness of autologous platelet-rich plasma in alleviating chronic post-thoracotomy pain syndrome. Ten patients with persistent thoracic post-surgical pain were consecutively recruited. Platelet-rich plasma was administered via ultrasound-guided perineural intercostal injections. Pain intensity, opioid consumption, and quality of life were assessed pre-treatment and at one- and three-month follow-ups.</div></div><div><h3>Results</h3><div>Platelet-rich plasma administration led to a significant reduction in pain intensity, with median Numerical Rating Scale scores decreasing from 8.5 to 3.0 at one month and 4.0 at three months post-treatment. At one month, 90 % of patients achieved a reduction in NRS scores exceeding the minimal clinically important difference (95 % CI: 71 %, 109 %), and this proportion was maintained at three months. Although opioid consumption showed a downward trend, it did not reach statistical significance. Improvements were observed in the EQ-5D-3L index and visual analogue scale scores, indicating enhanced quality of life post-treatment.</div></div><div><h3>Conclusions</h3><div>This prospective consecutive case series suggests that autologous platelet-rich plasma may offer a promising adjunctive therapy for chronic post-thoracotomy pain syndrome. However, limitations including the lack of a control group and small sample size underscore the need for further research to establish the efficacy and optimize the application of platelet-rich plasma in managing post-thoracotomy pain syndrome.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"3 4","pages":"Article 100448"},"PeriodicalIF":0.0,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142662515","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":"CT-guided indirect percutaneous facet synovial cyst rupture combined with direct fenestration: 10-year review at a single institution","authors":"Allison Y. Yang ,&nbsp;Troy A. Hutchins ,&nbsp;Lubdha M. Shah ,&nbsp;Lacey Woods ,&nbsp;Ghazaleh Safazadeh ,&nbsp;Blair A. Winegar ,&nbsp;Anna Hudson ,&nbsp;Miriam E. Peckham","doi":"10.1016/j.inpm.2024.100447","DOIUrl":"10.1016/j.inpm.2024.100447","url":null,"abstract":"<div><h3>Background</h3><div>Facet synovial cysts (FSCs) are benign, extradural outpouchings arising from the facet joint that can cause radiculopathy. Effectiveness of CT-guided indirect percutaneous cyst rupture (IPCR) alone and direct fenestration (DF) treatment alone have previously been reported in large cohorts. We performed a retrospective review of all FSCs treated under CT-guidance at a single institution where patients underwent IPCR, and IPCR followed by DF if necessary. We hypothesized that CT-guided FSC rupture would demonstrate similar effectiveness to previously reported fluoroscopic-guided methods, with potential improvement due to the opportunity to employ the DF technique in cases of IPCR failure.</div></div><div><h3>Methods</h3><div>A search was conducted of all CT-guided FSC rupture procedures over 10 years. Data included demographics, needle gauge used for IPCR and DF, rupture success, cyst size and T2 intensity, presence of spinal hardware, and cyst location. Subsequent surgery at the level of the cyst was documented.</div></div><div><h3>Results</h3><div>90 FSC rupture attempts were performed on 75 patients (28 M/47 F). FSC rupture using IPCR had a 70.0% success rate. In 22 FSC rupture attempts, IPCR failed and was followed by DF, with a success rate of combined IPCR + DF of 90.6 %. Subsequent surgery was required for 36.0% of patients involving the same level as the cyst or cysts.</div></div><div><h3>Conclusion</h3><div>Rates of successful FSC rupture under CT-guidance increased when the indirect rupture technique could be followed by direct fenestration in cases of failure. Our findings emphasize the benefits of flexibility afforded to the operator with CT-guidance.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"3 4","pages":"Article 100447"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142662514","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 relationship of PROMIS physical function scores and healthcare resource utilization in patients treated for chronic low back pain","authors":"Andre Hejazi ,&nbsp;Connor Willis ,&nbsp;Xiangyang Ye ,&nbsp;Jim Youssef ,&nbsp;Chip Moebus ,&nbsp;Ben Goss ,&nbsp;Bryan Cornwall ,&nbsp;Darrel Brodke ,&nbsp;Zachary L. McCormick ,&nbsp;Kenneth Schaecher ,&nbsp;Diana Brixner","doi":"10.1016/j.inpm.2024.100522","DOIUrl":"10.1016/j.inpm.2024.100522","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background context&lt;/h3&gt;&lt;div&gt;Patients with mechanical chronic lower back pain (CLBP) have few durable treatment options for their condition and thus suffer decreased productivity and have higher healthcare resource utilization (HRU) compared to patients without CLBP. The economic burden of treatment and ongoing care for CLBP is considerable, with healthcare spending in 2016 estimated at $134.5 billion in the United States.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;This study aims to assess the correlation between patient-reported physical function scores and HRU in patients treated for mechanical CLBP.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study design&lt;/h3&gt;&lt;div&gt;This was a retrospective cohort study within a university-based health system.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Patient sample&lt;/h3&gt;&lt;div&gt;Patients with a diagnosis of mechanical CLBP from 2015 through 2020 (index date) who were non-surgical candidates at baseline were included in this study. To ensure the presence of &lt;em&gt;chronic&lt;/em&gt; low back pain, patients were required to have encounters between 6 and 12 months as well as between 12 and 24 months following the date of CLBP diagnosis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Outcome measures&lt;/h3&gt;&lt;div&gt;Collected data variables included patient baseline characteristics, Patient-Reported Outcomes Measurement Information System - Physical Function (PROMIS-PF) scores, pharmacologic and non-pharmacologic therapies, HRU, and healthcare charges between January 2015 through December 2022.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;PROMIS-PF scores were converted to numerical categories ranging from 0 to 3, with Category 0 representing the lowest physical function and Category 3 the highest physical function. Patients were more broadly stratified into Low Physical Function (Low-PF) (Category 0–1) or High-Physical Function(High-PF) (Category 2–3) cohorts. HRU was compared between the Low-PF and High-PF cohorts using linear regression analyses. A mixed-effects regression analysis comparing Low-PF and High-PF patients was performed to model the relationship between patient-reported physical function and healthcare charges. The model is able to estimate charges for a base-case patient and can be adjusted to include patient-specific characteristics.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 2765 patients were included in this study, mean age was 50.1 (SD:17.7) years old, 23.6 % were 65 years or older, 68.4 % were female, and 85.3 % were white. Median healthcare charges by PROMIS-PF categories for Year-1 were highest for Category 0 patients ($14,028 [IQR: $5190-38,289]) and lowest for Category 3 ($5352 [IQR: $2417-14,470]). Patients in the Low-PF cohort showed significantly higher rates of all-cause, inpatient stays, outpatient visits, and emergency department (ED) visits compared to High-PF patients. The mixed effects regression model estimated cumulative healthcare charges to be &gt; 2-fold higher for a base-case patient in the Low-PF cohort compared to High-PF. A small portion of patients (n = 14) fail","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"3 4","pages":"Article 100522"},"PeriodicalIF":0.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142662513","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 sacral lateral branch radiofrequency neurotomy for posterior sacroiliac joint complex pain in patients selected by dual sacral lateral branch blocks; A real-world cohort study","authors":"Austin Boos ,&nbsp;Amanda Cooper ,&nbsp;Brook Martin ,&nbsp;Robert Burnham ,&nbsp;Allison Glinka Przybysz ,&nbsp;Aaron M. Conger ,&nbsp;Zachary L. McCormick ,&nbsp;Taylor R. Burnham","doi":"10.1016/j.inpm.2024.100442","DOIUrl":"10.1016/j.inpm.2024.100442","url":null,"abstract":"<div><h3>Background</h3><div>Previous study of spinal neurotomy procedures indicates that stringent block selection improves outcomes. However, this pattern is not established for sacral lateral branch radiofrequency neurotomy (SLBRFN). Few SLBRFN studies have used stringent block selection criteria such as ≥80 % pain reduction following dual sacral lateral branch blocks (SLBB).</div></div><div><h3>Objective</h3><div>Evaluate the effectiveness of SLBRFN in patients with ≥80 % pain relief following dual SLBBs.</div></div><div><h3>Methods</h3><div>Retrospective single-arm cohort study of consecutive patients from two Canadian musculoskeletal and pain clinics who underwent first-time SLBRFN after report of ≥80 % pain relief following dual diagnostic SLBBs. Patients were identified by electronic medical record query between 2016 and 2022. The primary outcome was the proportion of individuals with a ≥50 % reduction in the numeric pain rating scale (NPRS) score three months after SLBRFN. Secondary outcomes included the proportion of responders achieving the minimal clinically important difference (MCID) on the pain disability quality-of-life questionnaire (PDQQ), and the duration and mean percentage of pain relief among those with recurrent symptoms after a successful SLBRFN.</div></div><div><h3>Results</h3><div>Of the 70 participants included, 32 (45.7 %; 95 % CI = 34.6–57.3) reported a ≥50 % reduction in NPRS, and 35 (50.0 %; 95 % CI = 38.6–61.4) achieved the MCID on the PDQQ at 3-months. Among the 17 patients who reported a return of symptoms, the mean duration of relief was 8.0 ± 3.5 months, and the mean percentage of pain relief was 77.9 % ± 16.4 %. Logistic regression models revealed that the use of multi-tined RF probes and lower patient BMI were associated with treatment success.</div></div><div><h3>Discussion/conclusion</h3><div>SLBRFN reduced pain and disability in approximately 50 % of patients at 3 months when selected using relatively restrictive selection criteria. Treatment success was associated with multi-tined RF probe type and lower patient BMI. Larger prospective studies assessing long-term outcomes are needed to further evaluate the impact of different selection criteria and techniques on SLBRFN effectiveness.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"3 4","pages":"Article 100442"},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142555645","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":"C0-C1 joint injection: Anatomical, clinical and technical review","authors":"Christopher Mares ,&nbsp;Carl Majdalani","doi":"10.1016/j.inpm.2024.100443","DOIUrl":"10.1016/j.inpm.2024.100443","url":null,"abstract":"<div><h3>Background</h3><div>Cervicogenic headaches (CGH) are proven clinical entities. The prevalence of CGH arising from the atlanto-occipital (AO) joint is unknown. The best evidence for treatment of CGH is for third occipital nerve radiofrequency neurotomy. Treatment of CGH includes intra-articular injections into upper cervical spine joints.</div></div><div><h3>Objective</h3><div>To perform a review of the anatomy and clinical presentation of AO joint (AOJ) pain referral as well as a technical description to safely access the AOJ.</div></div><div><h3>Methods</h3><div>A literature review was performed to explore the intricacies of the cranio-cervical junction (CCJ) with a focus on the relation between the AOJ and vascular anatomy. Our technical approach is described with complementary images.</div></div><div><h3>Results</h3><div>The AOJ lies anterior to a venous sinus and slightly superior to the horizontally oriented vertebral artery crossing the joint line.</div></div><div><h3>Conclusion</h3><div>The authors propose a modified superior needle trajectory that seeks to avoid these vascular structures and to access the AOJ safely.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"3 4","pages":"Article 100443"},"PeriodicalIF":0.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142529552","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":"Key anatomical and clinical points about the superior cluneal nerves","authors":"Thomas Fichtner Bendtsen,&nbsp;Siska Bjørn,&nbsp;Thomas Dahl Nielsen","doi":"10.1016/j.inpm.2024.100445","DOIUrl":"10.1016/j.inpm.2024.100445","url":null,"abstract":"","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"3 4","pages":"Article 100445"},"PeriodicalIF":0.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142529550","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":"Factfinders for patient safety: Epidural steroid injection in patients with lumbar spinal stenosis","authors":"George Christolias ,&nbsp;Aditya Raghunandan ,&nbsp;Byron J. Schneider ,&nbsp;Kunj Amin ,&nbsp;David Hao ,&nbsp;Jaymin Patel ,&nbsp;International Pain and Spine Intervention Society's Patient Safety Committee","doi":"10.1016/j.inpm.2024.100444","DOIUrl":"10.1016/j.inpm.2024.100444","url":null,"abstract":"<div><div>This FactFinder presents a brief summary of the evidence suggesting that epidural steroid injections can be safely performed even in the setting of severe, multilevel lumbar spinal stenosis.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"3 4","pages":"Article 100444"},"PeriodicalIF":0.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142529551","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 the validation of thoracolumbar injury classification and severity score in the management of acute and subacute osteoporotic vertebral compression fractures","authors":"Alexander R. Vaccaro","doi":"10.1016/j.inpm.2024.100441","DOIUrl":"10.1016/j.inpm.2024.100441","url":null,"abstract":"","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"3 4","pages":"Article 100441"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433249","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":"Preoperative abdominal wall Botulinum A toxin in the outpatient pain clinic prior to complex abdominal wall repair: A letter to the editor","authors":"Kimberly Youngren,&nbsp;Armando Alvarez,&nbsp;Mikayleigh Pearson,&nbsp;Sarah E. Billmeier,&nbsp;Marissa Mendez,&nbsp;Brent White","doi":"10.1016/j.inpm.2024.100440","DOIUrl":"10.1016/j.inpm.2024.100440","url":null,"abstract":"","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"3 4","pages":"Article 100440"},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417624","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":"Letter to the editor: The use of XperGuide® needle guidance software for CT guided thoracic sympathetic block","authors":"Christiaan SJ. Hammerstein ,&nbsp;Sjoerd Servaas ,&nbsp;Erik GJ. Vermeulen ,&nbsp;Oscar BHAM. van Haagen","doi":"10.1016/j.inpm.2024.100439","DOIUrl":"10.1016/j.inpm.2024.100439","url":null,"abstract":"<div><p>With the introduction of modern cone beam computed tomography in the operating room, the benefits of imaging modalities in daily practice are recognized by an increasing number of clinicians. Newer generation imaging modalities include CT needle guidance software, which can aid the operator place the needle correctly during percutaneous intervention. This technique has several advantages over traditional percutaneous interventions, especially for high risk procedures like thoracic sympathectomy.</p><p>We describe and discuss outcomes and possible advantages of applying CT guided needle placement using needle guidance software (XperGuide®) for percutaneous thoracic sympathetic blockade in 8 patients. Based on our findings, we conclude that the use of high quality imaging and needle guidance software such as XperGuide® may improve patient outcomes, and reduce the risk of adverse effects, providing a relatively easy, safe, and valuable alternative treatment strategy for thoracic sympathectomies.</p></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"3 4","pages":"Article 100439"},"PeriodicalIF":0.0,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772594424000608/pdfft?md5=e887c9f33fa32c5811bbb43b8c7553c5&pid=1-s2.0-S2772594424000608-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142270672","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}