Pain physician最新文献

{"title":"Short-Term Trigeminal Ganglion Stimulation in Patients with Multi-Branch Trigeminal Herpetic Neuralgia: A Pilot Study.","authors":"Yong Zhang, Yanqing Wu, Cuihua Jiang, Ziwei Yang, Xuexue Zhang, Daying Zhang, Fan Yang, Yi Yan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Trigeminal herpetic neuralgia (THN) presents with severe pain hyperalgesia and is a high-risk factor for postherpetic neuralgia (PHN). The current clinical treatments for THN are unsatisfactory, and new treatments are desperately required.</p><p><strong>Objectives: </strong>This pilot study aimed to evaluate the efficacy of short-term trigeminal ganglion stimulation in treating patients with multi-branch THN.</p><p><strong>Study design: </strong>A prospective pilot study.</p><p><strong>Setting: </strong>Multi-center study in 3 academic hospitals.</p><p><strong>Methods: </strong>From July 2021 to October 2022, we enrolled 20 patients with multi-branch THN who received short-term trigeminal ganglion stimulation under general anesthesia from 3 hospitals. All patients completed a 12-month follow-up. The visual analog scale (VAS) and Pittsburgh Sleep Quality Index (PSQI) were used to assess patients' pain and quality of sleep. The Barrow Neurological Institute (BNI) score was used to determine the global outcome of pain relief, and complications were recorded.</p><p><strong>Results: </strong>Significant and sustained pain relief and sleep improvement were achieved by all the patients who underwent trigeminal ganglion electrode stimulation in the present study. Respective BNI scores of 80% and 85% at 3 and 12 months after surgery were considered good. There were no other serious complications except for 2 patients' experiences of transient trigeminal cardiac reflex during the surgery and transient numbness deterioration in one patient's V3 sensory area.</p><p><strong>Limitations: </strong>The present study is a pilot study. We expect prospective multi-center, large-sample studies in the future.</p><p><strong>Conclusion: </strong>Short-term trigeminal ganglion stimulation can be used safely and effectively to treat patients with multi-branch THN and significantly reduce the occurrence of PHN.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term Follow-up of the Effectiveness and Safety of High-voltage Pulsed Radiofrequency Treatment for Infraorbital Neuralgia: A Retrospective Study.","authors":"Zhe Sun, Lu Liu, Tao Wang, Fang Luo","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Infraorbital neuralgia is a refractory facial pain that may cause various psychological disorders. There is no optimal treatment for infraorbital neuralgia because few relevant studies have been conducted. Pulsed radiofrequency (PRF) is a minimally invasive procedure that has been proven effective in treating trigeminal neuralgia and other painful diseases. Our previous study demonstrated that high-voltage PRF was effective in patients with infraorbital neuralgia. However, there is little literature on the long-term follow-up of infraorbital neuralgia treated with high-voltage PRF with a large sample size.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To explore the long-term effectiveness and safety of high-voltage PRF guided by computed tomography for patients with infraorbital neuralgia who failed conservative treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Monocentric, retrospective, observational study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;This study enrolled patients with infraorbital neuralgia who failed conservative treatment for infraorbital neuralgia and who underwent a high-voltage PRF procedure at the Department of Pain Management in Beiging Tiantan Hospital.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;From January 2013 through June 2022, a total of 223 patients were included in this study; 16 were excluded according to the exclusion criteria. Finally, the medical records of 207 patients were extracted and analyzed including demographic data, intraoperative records, pain-related baseline, data and side effects. Treatment efficacy was evaluated using the Barrow Neurological Institute scores for pain. The Barrow Neurological Institute pain intensity score, onset time, perioperative complications and the time of recurrence were routinely followed up at month one, month 3, month 6 and every year postoperatively. Recurrence-free survival curves were presented by a Kaplan-Meier plot.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The initial pain relief rate after the high-voltage PRF treatment was 86.0%. The cumulative recurrence-free survival rates were 85.5% (at month one), 82.6% (at month 3), 77.8% (at month 6), 65.7%(at month 12), 61.7% (at month 24), 55.8% (at month 48), 47.6% (at month 96) and 45.2% (at month 120) postoperatively. The median follow-up time of the 207 patients was 67.0 months (interquartile range, 38.0-93.0 months; range from 12 months to 125 months), with a median recurrence-free time of 80 months according to the Kaplan-Meier estimator.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;This was a retrospective observational study. Multicenter, prospective, randomized controlled studies should be conducted. In addition, the optimal parameters for PRF treatment of infraorbital neuralgia need to be further explored.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Computed tomography-guided high-voltage PRF treatment provides a minimally invasive and effective treatment option for patients with infraorbital neuralgia who fail conservative treatment, which c","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National and Geographic Trends in Medicare Reimbursement for Pain Management 2014-2023.","authors":"George Wiest, Alexander Dorius, Carson Bateman, Miles Day","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Increasing enrollment in Medicare has coincided with reductions in reimbursement for various procedures, including interventional pain procedures. No previous analysis of state-to-state differences in Medicare reimbursement rates for practicing pain management physicians has been performed.</p><p><strong>Objective: </strong>To quantify recent national and geographical trends for interventional pain procedures.</p><p><strong>Study design: </strong>This study used datasets from the Centers for Medicare and Medicaid Services to identify the top 10 highest-grossing Current Procedure Terminology (CPT) codes for pain procedures and for evaluation and management (E/M) from 2014 to 2023. Data analysis took place during May 2023.</p><p><strong>Methods: </strong>Primary outcomes were calculated inflation-adjusted rates of yearly percent change (YPC) for each CPT code, state, territory, and U.S. Census region. An independent samples t-test compared the national YPC rates of procedure to those of E/M reimbursement. Medicare reimbursements throughout the United States for interventional pain procedures and clinic evaluations were measured from 2014-2023.</p><p><strong>Results: </strong>From 2014 to 2023, inflation-adjusted Medicare reimbursement for interventional pain procedures decreased yearly by an average of 3.63%. In comparison, clinic evaluation reimbursement decreased by only 0.87% yearly and was significantly different from procedure reimbursement (P < 0.001). Pain management procedure reimbursement decreased the most in Illinois (-4.26%), Wyoming (-3.88%), Wisconsin (-3.87%), Nevada (-3.83%) and Kansas (-3.82%). Meanwhile, rates for Puerto Rico (-1.94%), Massachusetts (-3.24%), Washington (-3.31%), New York (-3.39%), and West Virginia (-3.47%) decreased the least. When states were grouped into U.S. Census regions, no significant regional differences in pain management procedure reimbursement changes could be observed.</p><p><strong>Limitations: </strong>Only the facility prices of the top 10 highest-grossing procedure and E/M CPT codes that had available data for 2014 to 2023 could be included in our analysis; trends for private insurance reimbursement could not be analyzed.</p><p><strong>Conclusions: </strong>Medicare reimbursement rates for interventional pain procedures have decreased from 2014 to 2023, both nationally and in each region of the U.S. Our analysis suggests that certain states and territories have experienced less favorable reimbursement trends than others. This issue is worthy of attention as larger proportions of the U.S. population become eligible for Medicare coverage; should these trends continue, interventional pain physicians may consider moving their practices to areas that are less affected. Major efforts are required to preserve the quality of care that Medicare beneficiaries receive and to remedy the problem of depreciating reimbursement.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Errata.","authors":"Asipp","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Effectiveness of Radiofrequency Ablation of the Genicular Nerves of the Knee for the Management of Intractable Pain from Knee Osteoarthritis\".","authors":"Nurbanu Hindioglu Dogan, Savas Sencan, Serdar Kokar, Osman Hakan Gunduz","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Ultrasound-guided Transverse Carpal Ligament Release via Different Approaches in Carpal Tunnel Syndrome: A Prospective, Randomized, Controlled Trial.","authors":"Xiaochen Shi, Jiaan Zhu, Guicheng Li, Xuesong Gu, Hailin Xu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Ultrasound-guided transverse carpal ligament (TCL) needle release has been demonstrated to be an effective treatment for carpal tunnel syndrome (CTS). However, no existing evidence has investigated the comparative efficacy of different release approaches.</p><p><strong>Objective: </strong>To compare the efficacy of ultrasound-guided TCL needle release via different approaches for patients with mild to moderate CTS over a 12-month follow-up.</p><p><strong>Study design: </strong>A prospective, randomized, controlled trial.</p><p><strong>Setting: </strong>Outpatient clinic at a university hospital.</p><p><strong>Methods: </strong>Sixty-four patients with mild to moderate CTS (> 3 months' duration) were randomly assigned to either the long-axis group (one session of ultrasound-guided corticosteroid injection plus long-axis TCL needle release) or the short-axis group (one session of ultrasound-guided corticosteroid injection plus short-axis TCL needle release) in a one-to-one ratio. The primary outcomes were the symptom severity scale (SSS) and functional severity scale (FSS) scores of the Boston Carpal Tunnel Questionnaire (BCTQ). The secondary outcomes were electrophysiological studies, including distal motor latency (DML) and sensory nerve conduction velocity (SNCV), cross-sectional area (CSA) of the median nerve (MN), and patient-reported successful clinical response. Assessments were performed before treatment and at one, 3, 6, and 12 months after treatment.</p><p><strong>Results: </strong>A total of 60 patients (30 per group) completed the trial. Compared to the baseline, both groups exhibited improvement in SSS, FSS, SNCV, DML, and CSA at all follow-up time points, with statistical differences for SSS, FSS, and SNCV at 3, 6, and 12 months (P < 0.05), DML at 6 and 12 months (P < 0.05), and CSA at each follow-up time point (P < 0.05). Compared to the short-axis group, the long-axis group exhibited more improvement in SSS and FSS at all follow-up time points, with statistical differences at 3, 6, and 12 months (P < 0.05), and in SNCV and DML at 6 and 12 months (P < 0.05). Although the long-axis patients exhibited more improvement in their wrists' CSAs, the intergroup differences were nonsignificant at all follow-up time points (P > 0.05). Four patients in the short-axis group experienced recurrent symptoms and underwent surgery at 12 months, whereas no recurrence was observed in the long-axis group.</p><p><strong>Limitations: </strong>A relevant future trial with a longer follow-up period than this one used is still necessary.</p><p><strong>Conclusions: </strong>Ultrasound-guided TCL needle release via the long-axis approach appears to be more effective than the short-axis approach for treating mild to moderate CTS.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral Nerve Stimulation Using High-frequency Electromagnetic Coupling (HF-EMC) Technology to Power an Implanted Neurostimulator With a Separate Receiver for Treating Peripheral Neuropathy.","authors":"Ellen Lin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Peripheral neuropathy is estimated to be prevalent in up to 12% of the population, increasing to 30% in older demographics. This makes peripheral neuropathy one of the most common neurological diseases in the United States.</p><p><strong>Objectives: </strong>This retrospective study aims to report on the efficacy and safety of peripheral nerve stimulation (PNS) on the treatment of peripheral neuropathy in a commercial setting.</p><p><strong>Study design: </strong>This was a retrospective study. A chart review was conducted for all eligible study patients.</p><p><strong>Setting: </strong>This study was conducted at the Advanced Spine and Pain Center in San Antonio, a center focused on physical medicine and rehabilitation, pain management and advanced interventional procedures that effectively ease pain.</p><p><strong>Methods: </strong>From September 2018 through July 2022, a total of 63 consecutive patients with peripheral neuropathy who presented with chronic pain symptoms originating from the shoulder, hip, knee, ankle, and groin were trialed in this study. All patients were required to be at least 18 years old. These patients underwent PNS therapy via implantation of the Freedom® PNS System (Curonix LLC) in order to treat their chronic pain related to or due to peripheral neuropathy from various peripheral nerve origins.</p><p><strong>Results: </strong>The mean Numeric Rating Scale (NRS-11) score of 63 patients at baseline was 7.24 (SD, 1.80). At 2-3 weeks postimplantation, the mean NRS-11 score decreased to 3.43 (SD, 2.38). A total of 53 out of the 63 patients reported a reduction in their NRS-11 score at the 2-3 week follow-up. A total of 24 patients completed a long-term follow-up. The mean follow-up time was 763.13 days (SD, 428.42); all patients had their PNS system permanently implanted for at least 8 months (range, 255-1,592 days).</p><p><strong>Limitations: </strong>This was a retrospective study investigating the efficacy and safety of the Freedom® PNS System in patients with peripheral neuropathy. We were limited to the data available in the patient charts.</p><p><strong>Conclusion: </strong>PNS effectively treats chronic pain due to peripheral neuropathy for patients who have failed other conservative treatments.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delineating the Hurtful, Engaging, Emotive, and Directive (HEED) Dimensions of Pain. Characterization for Clinical Relevance.","authors":"James Giordano, John R Shook","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Pain is an objective, natural reality among sentient creatures that possess cognition and mobility sufficient for apprehending and acting upon its full significance. Defining pain mostly in mental terms makes sense for self-conscious psychology and vocabulary. Pain as a natural capacity among animals did not evolve merely to be aligned with human semantics and intuitions. Much about pain operates beneath the level of accessible and explicit consciousness, and pain as a sensory feeling probably arose before mammalian cognition. Pain should not be viewed as just a simple sensation of utter subjectivity. It displays qualitative variance, degrees of intensity, fluctuating durations, and deflects and/or captures attention. These features of pain situate it prominently within awareness amidst the myriad physical feelings and emotions that influence behavior. The significance of pain cannot omit felt painfulness, and pain wouldn't be painful without its urgent significance for redirecting bodily activity. Most pain shares characteristics of being hurtful, engaging, emotive, and directive (i.e.,- HEED). So delineated, pain evolved to be HEED-ed. Our proposed operational delimitation at first glance appears to be physiological, but its reliance upon the bio-psychosocial actuality of the painient organism renders it inter-theoretically reducible and expandable. This delineation of pain necessitates its being HEED-ed by the organism in which it occurs; and hence ethically heeded by those who profess to study and treat it.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on \"A Comprehensive Overview of the Stellate Ganglion Block Throughout the Past Three Decades: A Bibliometric Analysis\".","authors":"Eugene G Lipov","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Chronic Low Back Pain and Sleep Disturbance in Adults in the US: The NHANES 2009-2010 Study\".","authors":"Haozhu Chen, Jingjing Yang, Qing Zhang","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}