Pain and TherapyPub Date : 2025-03-27DOI: 10.1007/s40122-025-00726-6
Salah N El-Tallawy, Rania S Ahmed, Gehan I Salem, Tariq A Alzahrani, Mamdouh M Haddara, Radwa H Ahmed, Mohamed S Nagiub, Abdullah T Alsubaie, Mohamed M Ali, Mahmoud M Elbasha, Ahmed A Ahmed
{"title":"Neurological Deficits Following Regional Anesthesia and Pain Interventions: Reviewing Current Standards of Care.","authors":"Salah N El-Tallawy, Rania S Ahmed, Gehan I Salem, Tariq A Alzahrani, Mamdouh M Haddara, Radwa H Ahmed, Mohamed S Nagiub, Abdullah T Alsubaie, Mohamed M Ali, Mahmoud M Elbasha, Ahmed A Ahmed","doi":"10.1007/s40122-025-00726-6","DOIUrl":"https://doi.org/10.1007/s40122-025-00726-6","url":null,"abstract":"<p><p>Regional anesthesia (RA) has become an integral part of modern anesthesia practice and acute pain management strategies. It provides effective pain relief, reduces opioid consumption, and facilitates enhanced recovery after surgery. However, like any medical intervention, RA is not without risks. RA is associated with potential complications, including neurological deficits which can range from mild and transient to severe and permanent. These neurological deficits may result from non-adherence to established standards of care and deviations from the clinical practice guidelines. An online database search was conducted across multiple websites to identify the relevant articles. The inclusion criteria were articles in English, published between January 2010 and July 2024. The search included various study types, such as case series, observational studies, cross-sectional analyses, cohort studies, longitudinal studies, systematic reviews, and practice guidelines. A total of 38 articles met the inclusion criteria and were included in this comprehensive review which examines the neurological complications associated with regional anesthesia and pain interventions, with a particular focus on how deviations from the standards of care contribute to adverse neurological outcomes. Furthermore, it highlights preventive strategies aimed at minimizing the risks of these complications and improving patient safety.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721026","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":"Exploring the Role of the Cerebellum in Pain Perception: A Narrative Review.","authors":"Orita Manda, Marios Hadjivassiliou, Giustino Varrassi, Periklis Zavridis, Panagiotis Zis","doi":"10.1007/s40122-025-00724-8","DOIUrl":"https://doi.org/10.1007/s40122-025-00724-8","url":null,"abstract":"<p><p>This systematic review aims to reassess the expanding role of the cerebellum in pain perception, challenging its traditional and simplistic association with the motor domain. Pain perception is a complex experience shaped by sensory, emotional, and cognitive factors, with recent findings underlining the cerebellum's influence over these systems. This paper evaluates findings from 24 relevant studies to elucidate key findings with regard to pain and their potential clinical applications. The cerebellum's role in pain processing is assessed through its interaction with nociceptive pathways, pain anticipation, and the intonation of pain-related emotional responses. Key cerebellar regions such as Crus I, lobules VI and VIII, and the vermis, are persistently activated during pain perception and anticipation. These regions are linked to sensory-discriminative and affective-motivational elements of pain. Studies on patients with migraines, chronic low back pain, and irritable bowel syndrome (IBS) demonstrated increased cerebellar activation, suggesting its role in chronic pain conditions. Non-invasive neurostimulation techniques, such as transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS), administered onto these cerebellar regions, show potential in modulation of pain and clinical application. Future research should aim to standardise methodologies, explore the cerebellum's role in acute pain, and investigate long-term effects of cerebellar-targeted treatments. Understanding the cerebellum's multifaceted role in pain perception can advance diagnostic and therapeutic strategies, offering a more comprehensive approach to pain management. This review underscores the need for further investigation into cerebellar mechanisms and their clinical applications, potentially transforming pain treatment paradigms.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649957","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}
Pain and TherapyPub Date : 2025-03-15DOI: 10.1007/s40122-025-00718-6
Thalis Asimakopoulos, Athanasia Tsaroucha, Maria Kouri, Alberto Pasqualucci, Giustino Varrassi, Matteo Luigi Giuseppe Leoni, Martina Rekatsina
{"title":"The Role of Biomarkers in Acute Pain: A Narrative Review.","authors":"Thalis Asimakopoulos, Athanasia Tsaroucha, Maria Kouri, Alberto Pasqualucci, Giustino Varrassi, Matteo Luigi Giuseppe Leoni, Martina Rekatsina","doi":"10.1007/s40122-025-00718-6","DOIUrl":"https://doi.org/10.1007/s40122-025-00718-6","url":null,"abstract":"<p><p>Acute pain, a critical aspect of patient care, presents a challenge due to its subjective nature and complex biological underpinnings. Biomarkers for acute pain promise a paradigm shift in how pain is perceived, diagnosed, and managed. The study of genetic, inflammatory, and neurotransmission markers associated with pain experience may hold the key for the development of personalized and effective pain management strategies. This narrative review explores the neurobiological pathways of acute pain, encompassing inflammatory responses and neurotransmission mechanisms. It synthesizes current research on the identification and clinical application of biomarkers, emphasizing their potential to enhance diagnostic precision, treatment effectiveness, and risk prediction. We underscore the promising role of acute pain biomarkers in identifying patients at risk for developing acute and potentially chronic pain, predicting patients' response to pharmacological interventions, and aiding in the development of novel therapeutic and pain preventive strategies. The evolving landscape of biomarker research not only deepens our understanding of pain mechanisms but also lays the foundation for more tailored and patient-specific healthcare interventions.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634399","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}
Pain and TherapyPub Date : 2025-03-15DOI: 10.1007/s40122-025-00721-x
Mingrui Zhang, Keyue Xie
{"title":"Advances in Musculoskeletal Ultrasound for Assistive Diagnosis in Pain Clinics.","authors":"Mingrui Zhang, Keyue Xie","doi":"10.1007/s40122-025-00721-x","DOIUrl":"https://doi.org/10.1007/s40122-025-00721-x","url":null,"abstract":"<p><p>Musculoskeletal ultrasound has gained increasing attention as a noninvasive imaging modality in pain clinics. Its advantages include the lack of radiation exposure, cost-effectiveness, and efficiency, allowing for rapid provision of dynamic examination results. Notably, it has demonstrated significant effectiveness in diagnosing common joint injuries. This review synthesizes the advancements in the application of musculoskeletal ultrasound across various domains, including muscles, joints, bones, tendons, ligaments, and bursae. It explores the critical role of ultrasound in pain management, highlighting both its importance and limitations. Moreover, the review analyzes the latest research findings and the potential for clinical applications, underscoring the evolving landscape of musculoskeletal ultrasound in enhancing diagnostic accuracy in pain management.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634396","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}
Pain and TherapyPub Date : 2025-03-14DOI: 10.1007/s40122-025-00716-8
Janne Kristin Hofstad, Tina Strømdal Wik, Pål Klepstad, Kari Hanne Gjeilo, Siri Bjørgen Winther, Olav A Foss
{"title":"In-Hospital Pain and Opioid Consumption After Primary Total Knee Arthroplasty Compared to Primary Total Hip Arthroplasty: Results from 7330 Patients Treated in a Fast-Track Setting.","authors":"Janne Kristin Hofstad, Tina Strømdal Wik, Pål Klepstad, Kari Hanne Gjeilo, Siri Bjørgen Winther, Olav A Foss","doi":"10.1007/s40122-025-00716-8","DOIUrl":"https://doi.org/10.1007/s40122-025-00716-8","url":null,"abstract":"<p><strong>Introduction: </strong>Differences in in-hospital pain and consumption of opioids after primary total hip arthroplasty (THA) and knee arthroplasty (TKA) have been rarely studied in a setting where the patient course is otherwise similar. The aim of this study was to compare early pain intensity and opioid usage between patients who have undergone THA and TKA to identify potential implications for outpatient surgery.</p><p><strong>Methods: </strong>This institutional register study included 4655 patients receiving THA and 2675 patients receiving TKA. Pain at rest and during mobilization were collected once preoperatively, and postoperatively at five time-points, twice on the Day of surgery, once each on day 1 and day 2 after surgery, and at discharge, on a numeric rating scale (NRS) 0-10. Rescue opioids in oral morphine-equivalent doses (MME) were consecutively registered. Postoperative mobilization was registered twice daily.</p><p><strong>Results: </strong>Overall mean pain were 2.0 (Cl 2.0-2.0) after THA and 2.3 (Cl 2.3-2.4) after TKA at rest, and 3.3 (Cl 3.3-3.3) and 3.7 (Cl 3.7-3.8) during mobilization, respectively. Patients undergoing TKA had a transient increase in pain intensity the day after surgery, whereas patients undergoing THA had improved pain levels. Outpatient criteria for pain (NRS < 5 during mobilization) were feasible for 37% of THA and 35% of TKA. Total median MME was 30.0 (0-573) after THA and 52.5 (0-390) after TKA. Patients undergoing TKA were less mobilized during hospitalization.</p><p><strong>Conclusion: </strong>A comparable number of THA and TKA cases were eligible for same-day discharge based on outpatient discharge criteria for pain. Patients receiving TKA can expect an increase in pain intensity and opioid needs on the day after surgery.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634398","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}
Pain and TherapyPub Date : 2025-03-12DOI: 10.1007/s40122-025-00720-y
Antonio De Vincentis, Bin Cai, Marco Moscarda, Peter M F Barnes, Raffaele Antonelli Incalzi
{"title":"Naldemedine Use and Healthcare Resource Utilization in Patients treated with Opioid Analgesics for Chronic Non-Cancer Pain: Results of a Real-world Study in the USA.","authors":"Antonio De Vincentis, Bin Cai, Marco Moscarda, Peter M F Barnes, Raffaele Antonelli Incalzi","doi":"10.1007/s40122-025-00720-y","DOIUrl":"https://doi.org/10.1007/s40122-025-00720-y","url":null,"abstract":"<p><strong>Introduction: </strong>Opioid-induced constipation (OIC) is a common side effect of chronic opioid therapy that significantly impacts quality of life and healthcare costs. Naldemedine, a peripherally acting mu-opioid receptor antagonist, has shown efficacy in treating OIC. However, real-world evidence on naldemedine use in the United States is limited, particularly in older adults. We aimed to describe naldemedine use in real-world settings in the US, focusing on clinical characteristics, comorbidity profiles, co-prescribed medications, and healthcare resource utilization (HCRU), with a specific emphasis on older adults.</p><p><strong>Methods: </strong>This retrospective study analyzed data from the 2017-2022 Merative™ MarketScan<sup>®</sup> Commercial and Medicare Databases. We identified 2110 naldemedine users aged ≥ 30 years on chronic opioid therapy. Demographic and clinical characteristics, co-prescribed medications, and HCRU were evaluated. Subgroup analysis focused on patients aged ≥ 65 years.</p><p><strong>Results: </strong>The study cohort (66% women, median age 56 years, 14% aged ≥ 65 years) presented a significant comorbidity burden, with 57% having hypertension, 36% diabetes, and 25% chronic pulmonary disease with a Charlson Comorbidity Index ≥ 2 in 38% of subjects. Polypharmacy (i.e., use of five or more distinct drugs, excluding naldemedine) was very common (76%, 82% in ≥ 65 years). The most frequent indications for naldemedine were chronic back pain and radiculopathy. Oxycodone, hydrocodone, and morphine were the most commonly prescribed opioids. After initiating naldemedine, 30% of patients showed a reduction in hospitalizations per patient per year, with a more pronounced effect in older adults (37%). Potential drug-drug interactions with CYP3A4 inducers or inhibitors were infrequent and did not appear to impact HCRU.</p><p><strong>Conclusions: </strong>This real-world study demonstrates that naldemedine is predominantly used in middle-aged adults with comorbidities and polypharmacy. Naldemedine use was associated with reduced HCRU, particularly in older adults, suggesting potential benefits in managing OIC. The findings support the safety and effectiveness of naldemedine in real-world settings, including in older patients with multiple comorbidities.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616757","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}
Pain and TherapyPub Date : 2025-03-10DOI: 10.1007/s40122-025-00717-7
Alaa Abd-Elsayed, Trevor N Johnson, Kylie K Ruprecht, Tristan R Argall, Lukas J Henjum, Kenneth J Fiala
{"title":"Outcomes of Cooled Radiofrequency Ablation of Lumbar Nerves as Treatment for Chronic Low Back Pain.","authors":"Alaa Abd-Elsayed, Trevor N Johnson, Kylie K Ruprecht, Tristan R Argall, Lukas J Henjum, Kenneth J Fiala","doi":"10.1007/s40122-025-00717-7","DOIUrl":"https://doi.org/10.1007/s40122-025-00717-7","url":null,"abstract":"<p><strong>Introduction: </strong>Worldwide, 23% of adults suffer from chronic lower back pain, which is defined as pain persisting for more than 3-6 months [Merskey in Can J Psychiatry 34:329-336, 1989]. The lifetime prevalence of back pain is as high as 84% in adults [Casiano VE, Sarwan G, Dydyk AM, et al. Back Pain. [Updated 2023 Dec 11]. In: Stat Pearls [Internet]. Treasure Island (FL): Stat Pearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538173/ ]. Conservative treatment options for chronic low back pain include as needed or scheduled analgesics, physical therapy, anticonvulsants, exercise, weight loss, muscle relaxants, and much more. With chronic pain that is refractory to the aforementioned treatments, more invasive procedures may be indicated. Cooled radiofrequency ablation (CRFA), a minimally invasive therapy, utilizes internally cooled radiofrequency probes to deliver targeted thermal energy that causes neurolysis, disrupting the transmission of pain stimuli along nociceptive pathways, thus resulting in pain relief [Walker in J Spinal Disord 13:205-217, 2000 June]. This study investigates whether patients receiving CRFA for relief of chronic low back pain caused by lumbar facet arthropathy experience a reduction in pain scores, the length of this reduction in pain scores, and the magnitude of this reduction in pain.</p><p><strong>Methods: </strong>This study was a retrospective analysis of data extracted from UW-Health Electronic Medical Health records (EMR), encompassing lumbar CRFA procedures performed from 2015 through April of 2024. Patient data was obtained, including diagnosis, preoperative pain score, postoperative pain score, duration of relief, patient age, sex, and BMI. A two-tailed paired t test was used to statistically analyze the preoperative and postoperative pain scores, in which a p value ≤ 0.05 was considered significant.</p><p><strong>Results: </strong>A total of 1450 lumbar CRFA procedures were reviewed, and 206 were excluded due to absent pre- or post-op pain scores. An additional eight procedures were excluded due to weekly lidocaine infusions in between their procedure and reporting of their post-op score. 1026 CRFA patients were included in the analysis, comprising 584 females and 442 males with an average age of 59.81 ± 13.40 and a BMI of 31.67 ± 7.13. The average pre-procedure visual analog scale (VAS) pain score was 6.44 (6.44 ± 1.67, n = 1236), and the average post-procedure VAS pain score was 3.21 (3.21 ± 2.45, n = 1236) this achieved statistical significance (p < 0.0001). Improvement of pain symptoms was reported in 85.92% (n = 1062), 14.08% (n = 174) reported complete pain remission, 7.61% (n = 94) reported no change, and 6.47% (n = 80) reported worsening symptoms. For effective procedures (those with any amount of pain relief, n = 1062) with an available postoperative pain score, the mean percentage improvement was 60.56 ± 27.21%. The average duration of improvement wa","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597514","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 Relationship Between Treatment Satisfaction and Medication Understanding Among Patients Taking a Novel Oral Pain Reliever: A Questionnaire-Based Cross-Sectional Study.","authors":"Makio Takahashi, Sho Kodama, Maiko Akahane, Shuhei Yamamoto, Takashi Yonemoto, Haruhiko Seki","doi":"10.1007/s40122-025-00709-7","DOIUrl":"https://doi.org/10.1007/s40122-025-00709-7","url":null,"abstract":"<p><strong>Introduction: </strong>Patient satisfaction is important in pain management. Satisfaction with prescribed pain relievers and continued use of these drugs may be affected by a patient's understanding of their efficacy and safety. We investigated the association between patients' satisfaction and understanding of their prescribed medication for three oral pain relievers (lasmiditan, mirogabalin, and tramadol) that recently became available in Japan.</p><p><strong>Methods: </strong>This questionnaire-based, cross-sectional study included adult patients taking these oral pain relievers after April 2023. The primary endpoint was overall satisfaction (five-point rating) and the secondary endpoint was overall understanding (five-point rating) of the oral pain relievers.</p><p><strong>Results: </strong>In total, 328 patients (lasmiditan, 36.9%; mirogabalin, 55.5%, tramadol, 8.8%; four patients had been prescribed more than one medication) were included, and 71.6% of patients reported high satisfaction (score 4, 5) with their oral pain relievers (lasmiditan, 62.0%; mirogabalin, 76.1%; tramadol, 85.2%). The proportion of patients in the total population who reported a high understanding (score 4, 5) of their oral pain relievers was 68.0% (lasmiditan, 77.7%; mirogabalin, 63.3%; tramadol, 55.6%). In the total population and the lasmiditan and mirogabalin subgroups, the patient satisfaction level was significantly associated with scores on medication understanding (Cochran-Armitage test, p < 0.0001 for all). Discontinuation rates were higher in patients who were unsatisfied with their treatment than those who were satisfied (38.7% and 9.8%, respectively).</p><p><strong>Conclusion: </strong>This study showed that a higher level of understanding of oral pain relievers is associated with higher satisfaction, which may be associated with lower discontinuation rates.</p><p><strong>Clinical trial registration: </strong>UMIN000052629.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374239","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}
Pain and TherapyPub Date : 2025-02-01Epub Date: 2024-12-20DOI: 10.1007/s40122-024-00695-2
Matteo Luigi Giuseppe Leoni, Felice Occhigrossi, Michael Tenti, William Raffaeli
{"title":"Endoscopic Epidurolysis for the Management of Chronic Spinal Pain: A Delphi-Based Italian Experts Consensus.","authors":"Matteo Luigi Giuseppe Leoni, Felice Occhigrossi, Michael Tenti, William Raffaeli","doi":"10.1007/s40122-024-00695-2","DOIUrl":"10.1007/s40122-024-00695-2","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic epidurolysis (EE) is a minimally invasive procedure used to manage chronic spinal pain, particularly in cases unresponsive to traditional treatments. Despite its growing recognition, the literature lacks comprehensive guidelines on its optimal use. This study utilized a modified Delphi approach to gather expert consensus on best practices for EE in the Italian pain therapy network.</p><p><strong>Methods: </strong>The study's scientific board conducted an extensive literature review to define key investigation topics, including clinical indications, preoperative assessments, and technical aspects of EE. A semi-structured questionnaire was developed and administered to a panel of experts. A two-round Delphi process was implemented, with consensus defined as at least 70% agreement on a 7-point Likert scale (agree or strongly agree). Statements that did not reach consensus in the first round were rephrased and resubmitted in the second round.</p><p><strong>Results: </strong>Twenty-six clinicians participated in the study, with a 100% response rate in both rounds. In the first round, consensus was achieved for 9 out of 19 statements. In the second round, 8 out of 10 rephrased statements reached the consensus threshold. Key areas of agreement included the clinical indications for EE, the importance of preoperative imaging and anesthetic assessments, and the use of specific techniques and tools for EE. However, consensus was not reached on the use of EE for disc herniation with radicular pain and the safety of interlaminar access compared to sacral hiatus access.</p><p><strong>Conclusion: </strong>The study highlights the need for standardized protocols in EE to ensure consistent and effective treatment of chronic spinal pain. The consensus reached by the expert panel provides a framework for best practices, which can guide clinical decision-making and improve patient outcomes. Further research is necessary to validate these findings and address areas where consensus was not achieved.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"339-357"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain and TherapyPub Date : 2025-02-01DOI: 10.1007/s40122-024-00692-5
Andrew M Blumenfeld, Laszlo Mechtler, Lisa Cook, Christopher Rhyne, Brian Jenkins, Olivia Hughes, Brett Dabruzzo, Aubrey Manack Adams, Merle Diamond
{"title":"Correction to: Real‑World Evidence of the Safety and Effectiveness of Atogepant Added to OnabotulinumtoxinA for the Preventive Treatment of Chronic Migraine: A Retrospective Chart Review.","authors":"Andrew M Blumenfeld, Laszlo Mechtler, Lisa Cook, Christopher Rhyne, Brian Jenkins, Olivia Hughes, Brett Dabruzzo, Aubrey Manack Adams, Merle Diamond","doi":"10.1007/s40122-024-00692-5","DOIUrl":"10.1007/s40122-024-00692-5","url":null,"abstract":"","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"441-444"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}