Pain Medicine最新文献

{"title":"Platelet-rich plasma injections as a second-line treatment in patients with tendinopathy-related chronic pain and failure of conservative treatment: a systematic review and meta-analysis.","authors":"Mathieu Nadeau-Vallée, Sami Ellassraoui, Véronique Brulotte","doi":"10.1093/pm/pnaf022","DOIUrl":"10.1093/pm/pnaf022","url":null,"abstract":"<p><strong>Design: </strong>Platelet-rich plasma (PRP) is a popular treatment option in managing chronic tendinopathies, although the literature is inconsistent, mainly because of significant heterogeneity in patient populations. Patients who failed conservative management may respond differently than those who have not undergone first-line treatment. This systematic review and meta-analysis aimed to evaluate the efficacy of PRP injections in reducing pain and improving function in patients with chronic tendinopathy who failed conservative treatment. A comprehensive search of Medline, Embase, Cochrane Library, CINAHL Complete and Dissertations & Theses Global was conducted to identify randomized controlled trials (RCTs) comparing the effect of PRP vs non-surgical treatments on pain and functional outcomes in adult non-responders to conservative management.</p><p><strong>Results: </strong>A total of 9 RCTs involving 488 patients were included in the review. Of those, 6 studies at low risk of bias were included in the meta-analysis. PRP significantly reduced pain at both 6 and 12 months compared to control treatments (mean difference: -0.83 [95% confidence intervals (CI): -1.61 to -0.04] at 6 months; and -1.11 [95% CI: -2.10 to -0.12] at 12 months). This effect was also seen at 24 months, although based on limited data. Subgroup analysis revealed no significant differences in pain reduction between upper and lower limb tendinopathies. Functional improvement was observed in some studies, though the heterogeneity in outcome measures precluded a pooled analysis. Heterogeneity was substantial across studies, likely due to differences in PRP preparation, site of tendinopathy, and study methodologies.</p><p><strong>Conclusion: </strong>Despite these limitations, the findings suggest that PRP reduces pain in patients suffering from chronic tendinopathy who have not responded to first-line therapies. Further high-quality research with standardized protocols and longer follow-up is necessary to confirm PRP's long-term efficacy and safety.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"407-419"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal patterns of opioid dispensing dosages for compensated Australian workers with low back pain: a 3.5-year follow-up study.","authors":"Xinyi Ren, Ting Xia, Stephanie Mathieson, Christina Abdel Shaheed, Suzanne Nielsen, Alex Collie, Michael F Di Donato","doi":"10.1093/pm/pnaf017","DOIUrl":"10.1093/pm/pnaf017","url":null,"abstract":"<p><strong>Objective: </strong>To identify longitudinal patterns in opioid dispensing dosages for workers with low back pain within a workers' compensation setting and to explore the risk factors associated with high-dose and persistent opioid use.</p><p><strong>Method: </strong>We included workers with accepted claims for low back pain received by insurers between January 1, 2010, and June 30, 2016, with a follow-up period of 3.5 years (data censoring on December 31, 2020) across Victoria. Trajectory modeling was used to identify different opioid dispensing patterns. Logistic regressions were utilized to compare the workers' characteristics across different opioid dispensing pattern groups.</p><p><strong>Results: </strong>Among 14 703 accepted claims, 33.1% reported receiving opioid medications as part of their claims. Six opioid dispensing patterns were identified. Individuals in the highest socioeconomic status (SES) quintile were less likely to rapidly escalate to dispensing high-dose opioids (odds ratio [OR]: 0.58, 99% CI 0.34, 0.99) compared to other quintiles. Workers dispensed gabapentinoids and antidepressants showed an increased risk of long-term high-dose opioid use (OR: 7.96, 99% CI 5.42, 11.69; OR: 21.75, 99% CI 14.30, 33.08) relative to workers with a single opioid dispensing. Those who had surgery were also more likely to use long-term high-dose opioids compared to a non-surgery group.</p><p><strong>Conclusion: </strong>Lower SES, having gabapentinoids or antidepressants prescriptions or having had surgery are all associated with persistent opioid use among workers with LBP. These demographic and clinical risk factors for developing persistent opioid use could help identify individuals who would benefit from early intervention, reducing the likelihood of opioid dependence for pain management and minimizing the risk of harm.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"362-371"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and coding of opioid misuse: a systematic scoping review and implementation framework.","authors":"Robert W Hurley, Khadijah T Bland, Mira D Chaskes, Elaine L Hill, Meredith C B Adams","doi":"10.1093/pm/pnaf019","DOIUrl":"10.1093/pm/pnaf019","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate current administrative coding practices for opioid misuse (OM) within the World Health Organization's International Classification of Diseases (ICD) framework and develop standardized documentation recommendations.</p><p><strong>Design: </strong>Systematic scoping review following PRISMA-ScR guidelines.</p><p><strong>Setting: </strong>Analysis of studies using administrative databases, including electronic health records (EHRs), insurance claims, and national healthcare utilization databases.</p><p><strong>Subjects: </strong>Studies published in peer-reviewed journals examining administrative codes for OM, excluding those focused solely on illicit drugs, opioid use disorder (OUD), or using only natural language processing/qualitative methods.</p><p><strong>Methods: </strong>Comprehensive search of Embase, Medline, Google Scholar, and PubMed databases following PRISMA-S extension guidelines. Three independent reviewers screened articles and extracted data. Study quality was assessed using a modified Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>Of 9561 initial records, 19 studies met inclusion criteria. The use of ICD-10 code F11.9* (Opioid use) emerged as the most referenced method for documenting OM, distinguishing it from OUD methods (F11.1, opioid abuse; F11.2, opioid dependence). Studies demonstrated significant heterogeneity in coding practices, resulting in code-based definitions identifying only approximately 50% of cases compared to more comprehensive clinical assessment approaches.</p><p><strong>Conclusions: </strong>While ICD-10 code F11.9* can effectively document OM as distinct from OUD, successful implementation requires consensus on the clinical definition of OM and documentation in the form of clear clinical guidelines and operationalized through enhanced EHR integration. Future research should focus on validating these approaches across diverse healthcare settings.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"372-396"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone Remodeling, Not Inflammation, as the Predominant Pathology in Modic Type 1 Lesions of the Lumbar Spine.","authors":"Virginie Kreutzinger, Katharina Ziegeler, Cynthia T Chin, Misung Han, Emma Bahroos, Daehyun Yoon, Thomas M Link, Sharmila Majumdar","doi":"10.1093/pm/pnaf085","DOIUrl":"10.1093/pm/pnaf085","url":null,"abstract":"<p><strong>Purpose: </strong>Lesions of the vertebral endplates (Modic changes) are associated with low back pain (LBP), and different pathological processes, including inflammation, have been proposed as causative. This study aimed to explore the relationship between [18F]FDG uptake (inflammation) and [18F]NaF uptake (bone remodeling) and patient-reported back pain as well as conventional MRI detected endplate changes.</p><p><strong>Methods: </strong>Participants were selected from an IRB-approved study, creating two arms: [18F]NaF (n = 11) and [18F]FDG (n = 11). Scans were performed on a 3.0T PET-MRI scanner. An MSK radiologist rated endplates changes using Modic classification and a relative scale: none; only edema; edema > fat; edema=fat; edema< fat; only fat. Radiotracer uptake (SUVmax) in endplate-adjacent bone was measured using ROIs. VAS scores (0-10) for back pain were recorded before imaging. Generalized estimating equations assessed associations between pain and radiotracer uptake as outcomes and radiologic findings as predictors, adjusted for age, sex, and BMI.</p><p><strong>Results: </strong>The study included 220 endplates from 22 patients (110 per arm). Overall, pain was positively associated with edematous lesions (beta 0.21, p = 0.024), but not with fatty changes (beta 0.10, p = 0.567). In the [18F]NaF arm, tracer uptake was associated with edematous lesions (beta 1.79, p = 0.001) and with pain (beta 0.18, p = 0.007). In the [18F]FDG arm, tracer uptake was negatively associated with edematous lesions (beta -0.11, p = 0.013) and showed no significant association with pain (beta -1.50, p = 0.064).</p><p><strong>Conclusion: </strong>Our study shows that [18F]NaF-PET-MRI detected bone-remodeling is more closely linked to painful vertebral end-plate degeneration than inflammatory [18F]FDG signal.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of Noncancer Chronic Pain-Associated Ambulatory Care Visits, 2018-2019.","authors":"S Michaela Rikard, Wenyan Ma, Kristine M Schmit, Gery P Guy, Andrea E Strahan","doi":"10.1093/pm/pnaf084","DOIUrl":"https://doi.org/10.1093/pm/pnaf084","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and initial effectiveness of minimally invasive sacroiliac joint fusion with metal implants using a lateral transiliac approach: a prospective trial.","authors":"Jacqueline Weisbein, Denis Patterson, Douglas Beall, Dan Nguyen, Jack Smith, Caroline Harstroem, Timothy Davis, Jeffrey Foster, Anne Christopher, Daniel Kloster, John Broadnax, Eric Anderson, John Hatheway, Andrew Trobridge, Charles Simmons, Thomas Stauss, Michael Harned, Christopher Mallard","doi":"10.1093/pm/pnaf082","DOIUrl":"https://doi.org/10.1093/pm/pnaf082","url":null,"abstract":"<p><strong>Purpose: </strong>Sacroiliac joint (SIJ) pain, a frequent contributor to low back pain, is commonly treated with minimally invasive SIJ fusion. A large body of evidence supports the safety and effectiveness of lateral transiliac SIJ fusion. Traditionally performed by surgeons, this procedure is increasing in utilization by non-surgeon interventionalists. Herein, we present early safety results from a single-arm clinical trial of participants who underwent lateral SIJ fusion using threaded titanium implants placed by interventional pain management physicians.</p><p><strong>Methods: </strong>STACI (NCT05870488) is a two-year prospective study conducted at 15 US interventional pain management sites. The primary endpoint is change in SIJ pain from baseline to 6-months. Secondary endpoints include changes in function (Oswestry Disability Index), quality of life (PROMIS-29), device or procedure-related adverse events, and evidence of fusion on CT scan at 2 years.</p><p><strong>Results: </strong>110 patients were enrolled. Mean (SD) participant age is 64 (14) years and 68% are female. Mean (SD) operative time was 44 minutes (16) and estimated blood loss was 14 cc (15). No serious or device-related adverse events have occurred. Reported perioperative adverse events include one surgical site infection and one hematoma. At 1-month follow-up, ODI improved by 18 points (p < 0.0001) and SIJ pain (NRS) decreased by 4 pts (p < 0.0001) from baseline.</p><p><strong>Conclusion: </strong>Early results from this prospective multicenter study support the relative safety and early effectiveness of LTI SIJ fusion using a threaded implant when performed by interventional pain management physicians. The data are consistent with published literature with a low adverse event rate and early improvements in pain and function.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of serious spinal pathologies and non-spinal conditions in low back pain: A systematic review and meta-analysis.","authors":"Lorena S Reginato, Gustavo C Machado, Chris G Maher, Guilherme H D Grande, Ruben V C Vidal, Crystian B Oliveira","doi":"10.1093/pm/pnaf078","DOIUrl":"https://doi.org/10.1093/pm/pnaf078","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the prevalence of serious spinal pathologies and non-spinal conditions in people seeking care for LBP.</p><p><strong>Methods: </strong>Literature searches were conducted in six electronic databases. Observational studies investigating the prevalence of serious spinal pathologies and non-spinal conditions in adults seeking healthcare for a complaint of LBP were considered eligible. Risk of bias was assessed using a tool for prevalence studies. Meta-analyses using random effect models were conducted to obtain pooled prevalence estimates.</p><p><strong>Results: </strong>Eleven studies were included in this review; most (64%) at low risk of bias. Based on moderate certainty of evidence, the pooled prevalence of serious spinal pathologies was 2.9% (95% Confidence Interval: 1.6% to 5.2%) in people with a complaint of LBP at presentation. The prevalence however varied by setting: Primary care 0.8%, ED 2.1%, secondary care 4.6% and tertiary care 6.9%. Based on moderate certainty of evidence, the prevalence of individual serious spinal pathologies ranged from 0.3% for cauda equina syndrome to 2.4% for spinal fracture. The prevalence of non-spinal conditions from Australian ED studies varied greatly ranging from 21.5% to 58.3%.</p><p><strong>Conclusion: </strong>The prevalence of serious spinal pathologies and non-spinal conditions varied greatly. Differential diagnostic strategies with clear care pathways need to be available to ensure a prompt diagnosis of serious spinal pathologies and non-spinal conditions.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Ultrasound-Guided Genicular Nerve Neurolysis vs Sham Procedure on Pain in Patients With Knee Osteoarthritis: A Randomized Clinical Trial.","authors":"Malgorzata Reysner, Tomasz Reysner, Grzegorz Kowalski, Aleksander Mularski, Przemyslaw Daroszewski, Katarzyna Wieczorowska-Tobis","doi":"10.1093/pm/pnaf081","DOIUrl":"https://doi.org/10.1093/pm/pnaf081","url":null,"abstract":"<p><strong>Background: </strong>Knee osteoarthritis (OA) is a leading cause of chronic pain and disability, particularly in patients with symptomatic disease. While total knee arthroplasty (TKA) remains the standard treatment for advanced OA, many patients, especially older adults, are not suitable surgical candidates due to comorbidities or limited access to care. Minimally invasive options, such as chemical neurolysis of the superomedial genicular nerve (SMGN), superolateral genicular nerve (SLGN), recurrent tibial genicular nerve (RTGN), and inferomedial genicular nerve (IMGN), may offer meaningful pain relief and improved quality of life for this population.</p><p><strong>Objectives: </strong>To evaluate the efficacy and safety of ultrasound-guided chemical neurolysis using 95% ethanol targeting the four genicular nerves in patients with symptomatic knee OA who failed conservative treatment.</p><p><strong>Methods: </strong>In this double-blind, randomized, sham-controlled trial (NCT06087601), 100 patients with symptomatic knee OA were assigned to either ultrasound-guided genicular nerve neurolysis with 95% ethanol or a sham procedure. The primary outcome was pain intensity measured by the Numerical Rating Scale (NRS) at 7 days, 30 days, 3 months, and 6 months post-procedure. Secondary outcomes included opioid consumption and health-related quality of life, assessed via the EQ-5D-5L questionnaire. Safety outcomes included the occurrence of neurological complications. Analyses followed an intention-to-treat protocol, with appropriate handling of missing data.</p><p><strong>Results: </strong>Patients treated with ethanol neurolysis showed significantly greater reductions in NRS scores at all follow-up points compared to the sham group (p < 0.0001). Opioid consumption was also significantly lower in the neurolysis group throughout the study period (p < 0.0001). EQ-5D-5L scores indicated a significant improvement in quality of life (p < 0.0001). No neurological deficits or serious adverse events were reported.</p><p><strong>Conclusions: </strong>Ultrasound-guided chemical neurolysis of the SMGN, SLGN, RTGN, and IMGN using 95% ethanol is a safe, effective, and cost-efficient treatment for refractory knee pain in patients with symptomatic knee OA. This technique significantly reduces pain, lowers opioid reliance, and enhances quality of life, offering a valuable alternative for patients who are not candidates for surgical intervention.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid Dose, Duration, and Risk of Use Disorder in Medicaid Patients With Musculoskeletal Pain.","authors":"Allison Perry, Noa Krawczyk, Hillary Samples, Silvia S Martins, Katherine Hoffman, Nicholas T Williams, Anton Hung, Rachael Ross, Lisa Doan, Kara E Rudolph, Magdalena Cerdá","doi":"10.1093/pm/pnaf077","DOIUrl":"10.1093/pm/pnaf077","url":null,"abstract":"<p><strong>Objective: </strong>The CDC recommends initiating opioids for pain treatment at the lowest effective dose and duration. We examine how interactions between dose, duration, and other medication factors (e.g., drug type) influence opioid use disorder (OUD) risk-a gap not considered by CDC guidelines.</p><p><strong>Subjects: </strong>Using Medicaid claims data (2016-2019) from 25 states, we analyzed opioid-naïve adults, newly diagnosed with musculoskeletal pain who initiated opioids within three months of diagnosis. A 6-month washout confirmed no prior opioid exposure or musculoskeletal diagnosis.</p><p><strong>Methods: </strong>Initial opioids were categorized by \"dose-days supplied\" (low [>0-20 mg MME] to very high [>90 mg MME] dose, and short [1-7 days] to moderate [>7-30 days] supply), and by opioid type; physical therapy (PT) sessions were also recorded. Using Poisson regression models, we estimated the OUD risk associated with dose-days categories, adjusting for baseline demographics, clinical characteristics, and medications. We separately examined opioid dose-days and PT, and assessed PT's moderating effect on dose-days' impact.</p><p><strong>Results: </strong>Among 30,536 patients, half initiated opioids at 20-50 MME for 1-7 days, and 20% received PT. OUD risk was 2-3 times higher for opioids initiated for >7-30 days compared to 1-7 days across doses, and 5.5 times higher for opioids initiated for >7-30 days at > 90 MME versus 1-7 days at < 20 MME. PT alone, neither affected OUD risk nor mitigated the increased risk from longer or higher-dose opioids.</p><p><strong>Conclusions: </strong>Our findings support the need for careful opioid prescribing and alternative pain management strategies, as the observed associations between initial prescription characteristics and OUD were not mitigated by adjunctive PT.</p><p><strong>Perspective: </strong>This study demonstrated that initial opioid prescriptions of 7-30 days, especially above 90 MME/day, increased OUD risk in opioid-naïve patients with musculoskeletal pain; physical therapy did not mitigate the risk. Different opioids posed varied risks, even at the same dose and duration. Careful prescribing and alternative pain management are essential.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Provision of up-to-date magnetic resonance imaging conditionality for current peripheral nerve stimulation and spinal cord stimulation systems in pain management.","authors":"Peter D Vu, Matthew Slitzky, Kobe Miller, Robert J Yong, Christopher L Robinson, Matthew Chung","doi":"10.1093/pm/pnaf076","DOIUrl":"https://doi.org/10.1093/pm/pnaf076","url":null,"abstract":"<p><strong>Background: </strong>Magnetic resonance imaging (MRI) safety with implanted neuromodulation devices presents a critical challenge in modern medicine. While spinal cord stimulation (SCS) and peripheral nerve stimulation (PNS) devices are increasingly utilized for pain management, the scattered nature of manufacturer-specific MRI safety information creates substantial challenges for healthcare providers in making informed clinical decisions. Furthermore, despite the public availability of this information, a comprehensive review of the literature reveals no centralized repository of data regarding SCS and PNS.</p><p><strong>Objective: </strong>To synthesize comprehensive MRI safety data from multiple manufacturers of SCS and PNS devices into a centralized resource for clinicians, thereby streamlining the decision-making process for MRI scanning in patients with implanted neuromodulation devices.</p><p><strong>Methods: </strong>We collected MRI safety data for devices from ten major neurostimulation companies (Abbott, Biotronik, Boston Scientific, Curonix, Mainstay, Medtronic, Nalu, Nevro, Saluda, and SPR Therapeutics) through December 2024. Data collection involved direct communication with manufacturers and analysis of technical documentation to extract specific MRI-related parameters.</p><p><strong>Results: </strong>Full-body MRI safety at 1.5 T is standard across most SCS systems, with select devices permitting 3.0 T imaging. Specific limitations vary by manufacturer, including restrictions on spatial gradient magnetic fields (1,000-4,000 Gauss/cm), specific absorption rates, and active scan times (15-60 minutes). PNS systems show similar safety patterns.</p><p><strong>Conclusions: </strong>This manuscript addresses the urgent need for centralized safety information. As device technology continues to evolve, this resource will require ongoing updates to maintain its utility in supporting informed clinical decision-making and patient care.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}