Pain physician最新文献

{"title":"The Efficacy of the Minimally Invasive Lumbar Decompression (MILD®) Procedure: A PRISMA-compliant Systemic Review and Meta-analysis.","authors":"Xin-Yu Zhang, Jian-Li Zhao, Ya-Jing Wang, Jie Luan, Hong-Qi Lin, Dajie Wang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Lumbar spinal stenosis is the most common cause for spinal surgery of older adults. It is associated with pain in the legs and back as well as impaired ambulation. Minimally Invasive Lumbar Decompression (MILD®, Vertos Medical) is a percutaneous, image-guided lumbar decompression technique for central canal stenosis secondary to a hypertrophied ligamentum flavum. However, whether MILD can achieve adequate beneficial results in patients with lumbar spinal stenosis remains undetermined.</p><p><strong>Objective: </strong>To assess the efficacy and complications of MILD for lumbar spinal stenosis.</p><p><strong>Study design: </strong>A systematic review and meta-analysis.</p><p><strong>Methods: </strong>Electronic databases were searched to identify all clinical trials of patients undergoing MILD surgery. Primary outcomes included Visual Analog Scale scores (VAS) or Oswestry Disability Index scores (ODI) at baseline, < 6 months posttreatment, = one year posttreatment. Secondary outcomes included postoperative complications. For continuous variables, the treatment effects were calculated by weighted mean difference and 95% CI. The statistical significance was defined as P < 0.05.</p><p><strong>Results: </strong>There were 334 trials identified; 12 of them, with data from 500 patients, were included in our analysis. MILD treatment resulted in a significant decrease in the mean pain score compared to the baseline (P < 0.01). There is a consistent pattern of decreased mean ODI scores following MILD compared to the baseline (P < 0.01).</p><p><strong>Limitations: </strong>The included MILD clinical trials did not have the same exclusion and inclusion criteria. While all clinical trials in this study adopted conservative treatments prior to MILD, there were no standardized treatment modalities and length of time. All of the studies employed subjective outcome tools including VAS and ODI. However, these self-reported outcome tools are subject to bias.</p><p><strong>Conclusions: </strong>Our study suggests MILD is an effective and safe surgical technique for patients with stenosis from ligamentum flavum hypertrophy. This technique resulted in significant clinical improvement, as indicated by changes in pain scores and ODI scores. In addition, adverse events were low compared to other surgical decompression techniques. To further confirm this, more well designed and powered randomized trials are needed.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 2","pages":"71-81"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764675","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 \"Computed-Tomography-guided Percutaneous Bilateral Neurolytic Celiac Plexus Block with Alcohol for Upper Abdominal Visceral Cancer Pain\".","authors":"Qiuju Yi, Hui Zhong, Ling Ye","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 2","pages":"E227-E228"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764552","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":"Dilution of Ziconotide for Intrathecal Trial: The Effect of Dilution on the Incidence of Side Effects and Pain Relief: A Single-center Retrospective Case-control Study.","authors":"Anna Lynne Carpenter, Joseph Aaron McGuire, Edward Charles Nemergut, Kelsey Marie Bauer, Yeshvant Ashok Navalgund, David Carmine Scalzo, Richard Martin Vaglienti, Corinne Michel Layne-Stuart","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The optimal dosing and delivery strategies for intrathecal ziconotide are debated.  Previous research suggests that high volume, low concentration dosing techniques may decrease side effects and enhance analgesic effect. Previous studies that have investigated the effects of diluting ziconotide have examined continuous infusions of the medication through an intrathecal pump.</p><p><strong>Objectives: </strong>This study investigates the trial phase to determine if diluting the bolus dose leads to improved outcomes. The hypothesis of the authors is that the dilution of ziconotide will improve the trial outcomes.</p><p><strong>Study design: </strong>This single-center, retrospective, case-control study included 62 patients with chronic pain refractory to conservative therapy who received a one-time intrathecal bolus dose of ziconotide.</p><p><strong>Methods: </strong>The study included 62 patients who received a single outpatient trial dose of ziconotide. The study was approved by an institutional review board. Data were collected from electronic medical records. Doses ranged from a total of 2.5 µg-5 µg in a volume of 0.5 mL-5 mL. The primary endpoints were the number of patients that achieved significant pain relief (>= 50%) and the presence or absence of side effects. Statistical analysis was performed using a c2 test to evaluate side effects and meaningful pain relief and an unpaired, 2-tailed t test to evaluate pain relief percentage.</p><p><strong>Results: </strong>There were no differences in side effects experienced by the patients in the Undiluted Group compared to the patients in the Diluted Group (21% vs 25%; P = 0.679). There were no differences in pain relief in the Undiluted Group compared to the Diluted Group (59% vs 61%; P = 0.880). The mean (SD) pain relief in the Undiluted Group was 46% (± 40%) compared to 51% (± 41%) in the Diluted Group (P = 0.645). A power analysis revealed a 68% power to detect a difference between the groups.</p><p><strong>Limitations: </strong>These results are limited by the accuracy of the chart review and sample size; therefore, additional investigation may be warranted.</p><p><strong>Conclusion: </strong>This study demonstrates there is no substantial difference between diluted and undiluted bolus doses of intrathecal ziconotide in regard to analgesic effect or side effects.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 2","pages":"147-154"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764569","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":"The Causal Relationship Between Opioid Use and Obstructive Sleep Apnea: A Bidirectional Mendelian Randomization Study.","authors":"Guoliang Shan, Yufeng Ma, Yanwu Jin","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Opioid medications are widely used for pain management, but their impact on obstructive sleep apnea (OSA) remains controversial. Given the high prevalence of OSA and the increasing use of opioids, understanding the causal relationship between the condition and this type of medication is critical.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This study aims to investigate the causal relationship between opioid use and OSA using a bidirectional 2-sample Mendelian randomization (MR) analysis. Specifically, the study seeks to determine whether exposure to opioid use increases the risk of developing OSA and whether OSA influences the likelihood of opioid use.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;The study employed a bidirectional 2-sample MR analysis to explore the causal relationship between opioid use and OSA. Genetic variants from large-scale genome-wide association studies (GWAS) were used as instrumental variables to ensure robust causal inference.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;The study utilized data from 2 large-scale GWAS datasets. Opioid use data were obtained from the UK Biobank, while OSA data were sourced from the FinnGen study. Both datasets predominantly included patients of European ancestry with similar demographic characteristics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study employed a 2-sample bidirectional Mendelian randomization (MR) approach to investigate the causal relationship between opioid use and obstructive sleep apnea (OSA). Genetic instruments for opioid use and OSA were selected from large-scale genome-wide association studies (GWAS) conducted in European populations, ensuring consistency in genetic backgrounds. The inverse variance-weighting (IVW) method was used as the primary analysis to estimate causal effects, supplemented by the weighted median, MR-Egger, simple mode, and weighted mode methods to ensure robustness. Sensitivity analyses, including MR-Egger regression, leave-one-out analysis, and MR-PRESSO, were conducted to assess pleiotropy, heterogeneity, and the influence of individual SNPs on the results.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The IVW method demonstrated a significant causal effect of opioid use on the risk of developing OSA, with a causal effect size of 0.28 (OR = 1.32, 95% CI = 0.09 to 0.46, P-value = 0.004). This association was supported by the weighted median method, though the MR-Egger, simple mode, and weighted mode methods did not achieve statistical significance but showed a consistent direction of effect. Conversely, no significant causal relationship was observed between OSA and opioid use across all methods, suggesting that OSA did not significantly influence opioid use.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;The primary limitations of this study include the use of binary phenotypes for opioid use and OSA, which precludes the assessment of dose-response relationships. Additionally, the genetic data were derived predominantly from European populations, limiting the general","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 2","pages":"E147-E156"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764673","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 \"Effect of Epidural Volume Extension Using Low-Dose Sufentanil Combined with Low-Concentration Ropivacaine on Visceral Pain During Cesarean Sections: A Randomized Trial\".","authors":"Fei Gao, Dingping Zhou, Ling Ye","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 2","pages":"E231-E232"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764555","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 Response to Comment on \"Computed-Tomography-guided Percutaneous Bilateral Neurolytic Celiac Plexus Block with Alcohol for Upper Abdominal Visceral Cancer Pain\".","authors":"Huda F Ghazaly","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 2","pages":"E229"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764665","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":"The Tragedy of Chronic Pain and Its Psychosocial Impact: A Commentary on the Case of Luigi Mangione.","authors":"James Giordano","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This commentary explores the tragic case of Luigi Mangione, as detailed in Melanie Thernstrom's Wall Street Journal article, to address the complex interplay between chronic pain, psychological distress, and systemic inadequacies in healthcare. Chronic pain, as a biopsychosocial phenomenon, profoundly impacts not only physical functionality but also identity, cognition, and behavior, often leading to psychological destabilization and despair. Neurobiological evidence illustrates how chronic pain alters neural structures and functions, amplifying emotional reactivity and impairing judgment. Mangione's descent into violence exemplifies the detrimental cycle of pain, frustration, and alienation, exacerbated by systemic barriers such as inequitable healthcare access and insurance inadequacies. The discussion highlights the broader ethical implications for pain management, emphasizing the necessity of empathetic engagement, equitable care, and individualized therapeutic approaches. While advances in neurotechnology offer new diagnostic and interventional possibilities, their accessibility and integration into practice raise critical ethical concerns. Additionally, responsible opioid prescribing, informed by nuanced understanding of chronic pain, remains essential to addressing the dual challenges of effective pain relief and the opioid epidemic. This analysis calls for a comprehensive paradigm shift in pain care, integrating biopsychosocial methodologies, healthcare reforms, and ethical innovation. By addressing systemic inequities and prioritizing both high- and low-technology solutions, researchers, clinicians, and policymakers can better support patients and mitigate the far-reaching consequences of unaddressed chronic pain. Ultimately, this tragedy underscores the urgent need for actionable reform to prevent further individual and societal harm.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 2","pages":"E215-E218"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764676","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":"Resiliency is a Predictor of Clinical Outcomes in a Chronic Pain Cohort.","authors":"Gilbert S Chandler Iii, Phillip R Worts, Farnaz Solatikia, Philippe R Gaillard, Alexis M Rojas, Heather A Flynn","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Multidimensional strategies to improve pain have advanced the understanding of pain and pain treatment, yet the examination of biopsychosocial factors and associated treatments within pain management has not reached the mainstream.</p><p><strong>Objective: </strong>The objective of this study was to explore whether psychological variables added to routinely collected medical information were associated with clinical outcomes and the need for additional treatments after an initial chronic pain intervention.</p><p><strong>Study design: </strong>This prospective, observational study recruited patients during their initial pain management visits and followed them until they returned to the clinic for additional pain management.</p><p><strong>Setting: </strong>A private, multispecialty orthopedic clinic in Tallahassee, Florida.</p><p><strong>Methods: </strong>Patients were seeking treatment for their chronic pain. They completed a series of psychological evaluations, including the Patient Health Questionnaire 9 (PHQ-9), Generalized Anxiety Disorder Scale 7 (GAD-7), Avoidance-Endurance Questionnaire (AEQ), and Connor-Davidson Resilience Scale 10 (CD-RISC-10), in addition to answering lifestyle/behavioral questions. Chart reviews were performed at least one year from the patients' initial visits to understand the response to initial treatment and subsequent clinical management of their pain conditions.</p><p><strong>Results: </strong>One hundred fifty-two patients completed the full assessment, and 118 returned at least once to the clinic for continued medical care and were included in the models. A previous history of opioid use at the initial visit was a significant positive predictor of change in pain (P = 0.049). The CD-RISC-10 score was a significant negative predictor of the need for additional treatment at the patient's follow-up visit (P = 0.040). Thirteen percent of the cohort reported at least moderate symptoms of anxiety, and 26% of the cohort reported at least moderate symptoms of depression.</p><p><strong>Limitations: </strong>The limitations of this study were a lack of quantified opioid use and a reliance on self-reported measures.</p><p><strong>Conclusion: </strong>The inclusion of a resiliency measure along with established psychological instruments appears to add clinical value when managing patients with chronic pain. This study adds to the growing body of evidence that depicts resiliency as an important predictor of clinical outcomes.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 2","pages":"E173-E182"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764670","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":"Gray Matter Alterations in Medication Overuse Headache: A Voxel-Based Morphometry Meta-Analysis.","authors":"Weiming Luo, Yuke Teng, Xingyao Chen, Nuo Chen, Xinyue Zhang, Jun Zhou, Siyuan Tao, Peng Lai, Qian Song, Xinyu Hao, Fanrong Liang, Zhaoxuan He, Zhengjie Li","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Medication overuse headache (MOH) is a secondary headache disorder associated with the chronic use of pain-relieving medications, leading to significant alterations in brain structure and function. Previous studies have shown inconsistent findings in gray matter (GM) changes in MOH patients, making it necessary to conduct a comprehensive meta-analysis to synthesize these results.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The objective is to conduct a thorough review and meta-analysis of the consistency among voxel-based morphometry (VBM) neuroimaging studies that focus on MOH.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Systematic review and meta-analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;This meta-analysis examined all VBM studies that involved the whole-brain alterations of MOH.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A comprehensive search of neuroimaging studies was conducted across 6 databases, including EMBASE, PubMed, Web of Science, Wan-Fang Database, China National Knowledge Infrastructure (CNKI), and Chongqing VIP, covering publications from the inception thereof to December 1, 2023. Two independent researchers performed quality assessment, data extraction, and study selection. Researchers performed a thorough examination of GM data in MOH, utilizing both activation likelihood estimation (ALE) and Anisotropic effect size-signed differential mapping (AES-SDM). Additionally, the research included clinical variables correlation analysis and subgroup analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 8 studies were selected for analysis based on stringent screening criteria, resulting in the inclusion of 378 patients (comprising 191 patients with MOH and 187 healthy patients). The 2 different neuroimaging meta-analysis methods both revealed that MOH patients had increased amounts of GM in their cerebellar vermis, left red nuclei, and right medial dorsal nuclei. Additionally, MOH patients showed reductions in the GM of their left superior frontal gyri, left inferior frontal gyri, right precunei, and bilateral middle frontal gyri. Correlation analysis findings indicated that numerous cerebral areas were linked to clinical variables of MOH, including the duration of the condition, frequency of headaches, and patient age. MOH patients using different medications exhibited partially inconsistent GM alterations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;The limited number of neuroimaging studies and the variability in methodologies across studies might have affected the robustness of the findings. Future research should address these gaps by exploring both structural and functional neuroimaging in diverse MOH subtypes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Significant alterations in GM across various brain regions associated with pain processing, modulation, and reward have been observed in association with MOH. These observations contribute to a better understanding of the neural mechanisms underlying MOH and may potentially guide the developm","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 2","pages":"E115-E127"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764609","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":"Influence of Lumbar Epidural Steroid Injection on Osteoporosis and Denosumab Treatment.","authors":"Jun-Han Kim, Jeong-Mo Koo, Dong-Eun Shin, Tae-Keun Ahn","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Lumbar epidural steroid injections (ESIs) are commonly used to alleviate pain associated with lumbar disorders. However, administering steroids to patients with osteoporosis may lead to a decline in bone mineral density (BMD) and increase fracture risk. While various steroids are utilized in ESIs, limited research exists on their effect on BMD.</p><p><strong>Objectives: </strong>This study aimed to analyze the effect of dexamethasone-based ESI therapy on osteoporosis in patients receiving or not receiving denosumab, utilizing real-world clinical data.</p><p><strong>Study design: </strong>Retrospective analysis.</p><p><strong>Setting: </strong>A university hospital orthopedic department.</p><p><strong>Methods: </strong>A retrospective review was conducted, incorporating patients who underwent denosumab therapy alongside ESIs for pain alleviation from January 2018 through April 2022. Eligibility criteria included patients with a minimum follow-up period of 12 months. Forty patients who had received an ESI and denosumab treatment were enrolled in Group One. Similarly, 35 patients who had only received an ESI (Group 2) and 33 patients who underwent denosumab treatment alone (Group 3) were enrolled and analyzed. Statistical analysis was performed using analysis of variance (ANOVA) to compare patient age, gender, lumbar and  hip BMD, difference in lumbar and hip BMD at postinjection one year, serum vitamin D, calcium, phosphorus levels, and one-year cumulative steroid dosage.</p><p><strong>Results: </strong>In terms of patient demographics, the mean age of Group One was 71.73 (± 9.59) years, Group 2 was 70.00 (± 9.82) years, and Group 3 was 71.18 (± 5.64) years. The ANOVA analysis revealed no significant differences among groups. The BMD analysis showed that the lumbar BMD in Group One was 0.811 g/cm2, Group 2 was 0.831 g/cm2, and Group 3 was 0.822 g/cm2. Hip BMD in Group One was 0.696 g/cm2, Group 2 was 0.711 g/cm2, and Group 3 was 0.668 g/cm2. The change in BMD values showed that in Group One, lumbar BMD increased by 0.0411 g/cm2 compared to baseline, a 5.06% increase, while hip BMD increased by 0.0047 g/cm2, a 0.68% increase. In Group 2, lumbar BMD decreased by -0.0307 g/cm2, a 3.7% decrease, and hip BMD decreased by -0.036 g/cm2, a 5.02% decrease. In Group 3, lumbar BMD increased by 0.056 g/cm2, a 6.77% increase, while hip BMD increased by 0.005 g/cm2, a 0.69% increase.</p><p><strong>Limitations: </strong>The number of patients recruited was relatively small and limited to specific age groups. Study design was retrospective.</p><p><strong>Conclusion: </strong>Lumbar ESIs with dexamethasone reduce BMD in elderly patients with osteoporosis. However, when denosumab is administered alongside dexamethasone-based ESIs, the steroid does not significantly affect the decline of BMD.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 2","pages":"E183-E189"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764666","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}