Pain Practice最新文献

{"title":"Dr. Gabor Bela Racz-A Life of Impact and Innovation.","authors":"Carl Noe","doi":"10.1111/papr.70152","DOIUrl":"https://doi.org/10.1111/papr.70152","url":null,"abstract":"","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":"26 4","pages":"e70152"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594027","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":"Sphenopalatine Ganglion Radiofrequency Ablation for Severe Facial Rosacea Manifestations.","authors":"Leonardo Kapural, Lasha-Georgi Esebua, Neil Poddar, Carmen Bekavac, Gil Yosipovitch","doi":"10.1111/papr.70151","DOIUrl":"https://doi.org/10.1111/papr.70151","url":null,"abstract":"<p><strong>Background: </strong>Rosacea is an inflammatory, persistent erythema that can present under several clinical subtypes. Recently, a neurogenic type of rosacea has been suggested that can be associated with chronic pain and headaches.</p><p><strong>Aims: </strong>Here we describe a successful interventional treatment for severe, likely neurogenic rosacea associated with severe migraines previously treated using various conservative approaches.</p><p><strong>Materials and methods: </strong>Radiofrequency ablation of the sphenopalatine ganglion (SPG) was completed for the patient's primary chronic pain problem, severe migraine headaches.</p><p><strong>Results: </strong>Completion of the left-sided ganglion denervation resulted in resolution of left facial rosacea symptoms/signs. After the right radiofrequency denervation (about 2 weeks later), rosacea signs/symptoms disappeared from the right side of the patient's face as well. Twelve months following the sphenopalatine radiofrequency ablation, the patient is still rosacea-free.</p><p><strong>Conclusion: </strong>A larger case series is needed to assess the efficacy of sphenopalatine radiofrequency ablation in long-term management of the facial subtype of rosacea.</p>","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":"26 4","pages":"e70151"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594046","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":"Prognostic Value of Selective Nerve Root Blocks Prior to Pulsed Radiofrequency in the Treatment of Patients With Chronic Radicular Pain: A Systematic Review.","authors":"Marius R van Ooijen, Sezai Özkan, Koen van Boxem, Kris C P Vissers, Sandra A S van den Heuvel","doi":"10.1111/papr.70132","DOIUrl":"10.1111/papr.70132","url":null,"abstract":"<p><strong>Background/importance: </strong>Selective nerve root blocks (SNRBs) are frequently used in clinical algorithms for managing chronic radicular pain. However, their prognostic value in identifying patients likely to benefit from pulsed radiofrequency (PRF) treatment remains uncertain.</p><p><strong>Objective: </strong>This systematic review evaluates whether a positive response to an SNRB predicts improved clinical outcomes following PRF in patients with chronic radicular pain.</p><p><strong>Evidence review: </strong>A systematic search was conducted in PubMed, Embase, and Cochrane databases, along with reference lists of relevant articles. Eligible studies included patients with chronic radicular pain and assessed the prognostic role of SNRBs administered prior to PRF. Risk of bias was assessed using the ROBINS-I V2 tool.</p><p><strong>Results: </strong>Only one prospective observational study met inclusion criteria. In patients with chronic lumbosacral radicular pain, a positive SNRB response was associated with a higher likelihood of treatment success at 6-week follow-up (odds ratio: 3.26; 95% CI: 0.97-11.00; p = 0.06). Multivariate analysis identified limited baseline disability, age > 55 years, and a positive SNRB response as predictors of success at 6 months, with an area under the receiver operating characteristic curve of 0.73.</p><p><strong>Conclusions: </strong>This review identified a lack of published studies-aside from one prospective observational study-examining the prognostic value of SNRBs in the context of PRF for chronic radicular pain. The findings underscore not only a lack of high-quality evidence but a broader gap in the literature. Further robust research is warranted to clarify the clinical utility of SNRBs in guiding PRF treatment decisions.</p>","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":"26 3","pages":"e70132"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12963952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366261","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":"Treatment of Glossopharyngeal Neuralgia: A Systematic Review.","authors":"Marcelo A Rohde, Lorenzo Gabriel A Viera, Aline O S Meneses, Helena F S Rypl, Laura P Nunes, Victor Hugo W Annes, Amauri Dalla-Corte","doi":"10.1111/papr.70144","DOIUrl":"10.1111/papr.70144","url":null,"abstract":"<p><strong>Introduction: </strong>Glossopharyngeal neuralgia (GPN) is a rare neuropathy characterized by paroxysmal, unilateral, and severe pain episodes affecting the throat, tonsils, base of the tongue, and pharynx. Its management remains challenging due to the absence of standardized treatment protocols and the limited availability of high-quality comparative studies.</p><p><strong>Objective: </strong>To review and compare the effectiveness and safety of available treatments for GPN.</p><p><strong>Methods: </strong>A systematic review was conducted, analyzing studies published in the last decade that evaluated GPN treatments. Searches were performed in PubMed, SCIELO, and the Regional Portal of BVS. Studies were assessed for quality, risk of bias, and key outcomes, including pain relief and adverse effects.</p><p><strong>Results: </strong>Twenty-six studies, comprising 973 patients, were included. Seven treatment modalities were analyzed. Microvascular decompression (MVD) demonstrated the highest efficacy and durability, with an immediate pain relief rate exceeding 86.7% and exhibiting the lowest recurrence rates. Alternative treatments, including gamma knife radiosurgery, radiofrequency thermocoagulation, and pulsed radiofrequency, showed initial pain relief but had higher recurrence rates over time. The posterior inferior cerebellar artery was the most frequently involved vessel in cases with vascular compression.</p><p><strong>Conclusion: </strong>MVD is the preferred first-line surgical treatment when pharmacological therapy fails, vascular compression is present, and the patient is a suitable candidate for surgery. In cases where MVD is contraindicated or vascular compression is absent, alternative treatments should be considered based on individual patient factors, balancing efficacy and long-term outcomes. Further high-quality studies are needed to refine treatment strategies for GPN.</p>","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":"26 3","pages":"e70144"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147369998","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":"Response to the Letter Commenting on: \"Twenty-One-Year Experience With Cervical Diagnostic Blocks and Denervation: A Study of 1031 Cases at a Single Institution\".","authors":"Thomas Mirland, Lara Chow Yuen, Nathalie Van Cutsem, José Cravo, Olivier Duranteau, Turgay Tuna","doi":"10.1111/papr.70135","DOIUrl":"https://doi.org/10.1111/papr.70135","url":null,"abstract":"","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":"26 3","pages":"e70135"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366269","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":"Radiologic Insights: Diagnosing Lumbosacral Transitional Vertebrae. Systematic Review of the Literature.","authors":"Pedro Andrade-Andrade, Juan Carlos Acevedo-González","doi":"10.1111/papr.70138","DOIUrl":"10.1111/papr.70138","url":null,"abstract":"<p><strong>Introduction: </strong>The lumbosacral transitional vertebra (LSTV) has been studied since 1876, with Castellvi developing a classification in 1984 based on its anatomy and laterality. It often goes unnoticed, or its diagnosis is limited to a lumbar spine X-ray for confirmation. This has led to LSTV being underdiagnosed or even ignored. Our aim is to describe and evaluate radiological diagnostic techniques for LSTV and propose a diagnostic methodology to reduce errors in vertebral level identification, useful for percutaneous procedures and/or biomechanical measurement analysis.</p><p><strong>Materials and methods: </strong>A systematic literature review was conducted. The search terms included: \"Castellvi,\" \"Lumbosacral Transitional Vertebra,\" \"Radiology.\" Logical connectors such as \"and\" and \"or\" were applied. The following databases were reviewed: Scopus, PubMed, Ovid, ScienceDirect, EBSCO, and Nature. The timeframe was limited from 2004 to December 2024. Inclusion and exclusion criteria were applied. A total of 419 articles were identified. The \"Rayyan\" program was used to compile information, and \"PRISMA,\" \"STROBE,\" and \"CONSORT\" were used to facilitate the analysis process.</p><p><strong>Results: </strong>Forty-eight articles were included and analyzed (10 CT, 4 PET-CT, 2 bone scans, 9 MRI, 6 X-rays, 4 EOS, and 13 mixed). The most common findings highlighted CT as the gold standard for diagnosing LSTV, with spinopelvic parameters correlating with LSTV. Radiography is effective for vertebral numbering. MRI studies utilize anatomical landmarks to identify vertebral levels and LSTV, although they are less sensitive. EOS is also used for vertebral level identification.</p><p><strong>Conclusions: </strong>Our proposed diagnostic methodology for LSTV includes: first, using plain AP radiography for cranial-to-caudal vertebral numbering and evaluating morphological anomalies. Second, if LSTV is suspected, performing CT as the gold standard for diagnosis due to its high sensitivity and specificity, and measuring spinopelvic parameters to correlate with LSTV. Third, using MRI in special cases. Fourth, conducting a morphological analysis and using Jenkins' classification for LSTV categorization.</p>","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":"26 3","pages":"e70138"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378342","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":"Author's Response to Letter to the Editor Regarding \"Efficacy and Safety of Once-Daily Prolonged-Release Pregabalin for the Treatment of Patients With Diabetic Peripheral Neuropathy: A Randomized, Double-Blind, Active, and Placebo-Controlled Trial\".","authors":"Shilpi Dhawan, Amol Bongirwar, Marta Muñoz-Tudurí, Aman Khanna Romesh, Prakash H Kurmi, Rahul Tulshidas Jankar","doi":"10.1111/papr.70126","DOIUrl":"https://doi.org/10.1111/papr.70126","url":null,"abstract":"","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":"26 3","pages":"e70126"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147434719","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":"Management of a Hypoglossal Nerve, Upper Airway Stimulator in the Pain Patient: Safety Considerations.","authors":"Kenneth B Chapman, Steven Yusufov, Casey Grillo, Tariq A Yousef","doi":"10.1111/papr.70141","DOIUrl":"https://doi.org/10.1111/papr.70141","url":null,"abstract":"<p><strong>Background: </strong>Upper airway stimulation (UAS) is an emerging neuromodulatory treatment for obstructive sleep apnea (OSA). It involves stimulating the motor fibers of the hypoglossal nerve to prevent airway collapse. Patients with OSA and pain may require radiofrequency ablation (RFA) or electrocautery during surgery. Due to the proximity of UAS leads to cervical facet joints, careful procedural considerations are necessary to prevent complications. This report summarizes best practices for performing RFA or electrocautery in patients with UAS implants, guided by manufacturer safety recommendations and expert consensus statements.</p><p><strong>Case presentation: </strong>An elderly patient with OSA, successfully treated with Inspire UAS, and chronic cervical facet-mediated pain presented for repeat cervical RFA. The procedure followed manufacturer safety recommendations, including turning off the UAS device prior to the intervention, positioning the grounding pad to avoid current passage through the implant, maintaining distance from the device leads, and using bipolar RFA. The RFA was performed without complications, and the patient experienced significant pain relief without adverse effects.</p><p><strong>Conclusion: </strong>This case underscores the importance of thorough preprocedural planning when performing RFA in patients with implanted neuromodulation devices. Adhering to manufacturer guidelines can reduce the risk of device interference and associated complications.</p>","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":"26 3","pages":"e70141"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372995","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":"Reply to the Letter to the Editor \"Toward a Finer-Grained Understanding of Greater-Occipital-Nerve Block Duration in Migraine\".","authors":"Alessandro Viganò, Giada Giuliani, Vittorio Di Piero, Marta Altieri","doi":"10.1111/papr.70145","DOIUrl":"https://doi.org/10.1111/papr.70145","url":null,"abstract":"","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":"26 3","pages":"e70145"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147390547","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":"Novel Dual-Array Ultrasound Technology for Neuraxial Injections: Evaluation of Thoracic and Lumbar Facet Joint Injection Accuracy.","authors":"Eric A Jones, Edward A Pingenot, Richard Kim, Amitabh Gulati","doi":"10.1111/papr.70143","DOIUrl":"10.1111/papr.70143","url":null,"abstract":"<p><strong>Introduction: </strong>Ultrasound-guided neuraxial injections are less accurate than fluoroscopy-guided techniques due to limited needle visualization, particularly in out-of-plane approaches. A novel dual-array ultrasound probe developed by Rivanna Medical Inc., enables in-plane visualization of needle trajectory even when inserted perpendicularly. This study evaluates the accuracy of this novel technology in thoracic and lumbar facet joint injections.</p><p><strong>Methods: </strong>A prevalidation study was conducted using one cadaver. One interventional pain physician independently performed facet joint injections using the dual-array ultrasound system. The system integrates two rotated 64-element curvilinear arrays configured to transmit and receive at 2.5 MHz with multiangle electronic beam steering (three angles per array) and real-time dual-array image blending/compounding, enabling visualization of both anatomy and the full in-plane needle trajectory. Injection accuracy was confirmed via fluoroscopy.</p><p><strong>Results: </strong>All six injections successfully targeted the intended region. Two injections were classified as Grade 1, three as Grade 2, one as Grade 3, and zero as Grade 4.</p><p><strong>Conclusions: </strong>The dual-array ultrasound system shows promise in enhancing the accuracy of thoracic and lumbar facet joint injections by enabling in-plane needle visualization even at steep angles. Our findings highlight the potential of this technology to improve procedural precision, while also underscoring the learning curve associated with its use. These feasibility results support further validation for spine interventions requiring steep needle trajectories, and future studies should evaluate true neuraxial applications (e.g., epidural/intrathecal) with quantitative needle-tip localization metrics.</p>","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":"26 3","pages":"e70143"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366223","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}