Pain Practice最新文献

{"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":"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":"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":"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":"The Effects of Invasive Motor Cortex Stimulation for Neuropathic Pain: Do We See the Full Picture?","authors":"Erkan Kurt, Eline Bijl, Inge Arnts, Suzanne Pouwels, Linda Kollenburg, Jeremy Hanemaaijer, Robert van Dongen, Yvonne Engels, Kris C P Vissers, Dylan J H A Henssen","doi":"10.1111/papr.70123","DOIUrl":"10.1111/papr.70123","url":null,"abstract":"<p><strong>Introduction: </strong>Invasive motor cortex stimulation (iMCS) can be a last-resort treatment of chronic neuropathic pain syndromes. There is evidence that iMCS was found to influence pain intensity, quality of life scores, and pain medication intake in clinical practice. Albeit, qualitative studies published over the last years showed that the expectations and experiences of patients have a significant impact on treatment outcomes. This paper focus on these experiences of chronic neuropathic pain patients treated with iMCS.</p><p><strong>Objectives: </strong>The aim of this interview study was to map the experiences of patients treated with iMCS in order to evaluate the multidimensional effects of iMCS.</p><p><strong>Materials and methods: </strong>Twenty-eight patients with chronic neuropathic pain treated with iMCS between 2005 and 2018 were interviewed individually. All interviews were semi-structured using a predefined topic list. An inductive iterative process was performed during the interviews using the constant comparative method. All interviews were audio-recorded and transcribed verbatim afterwards. Transcripts were coded using direct content analysis. The derived codes were structured into categories and themes. Basic quantitative demographic data were collected, and the decrease in pain intensity after 2 years iMCS was calculated.</p><p><strong>Results: </strong>Content analysis of the interviews revealed ten relevant categories, which could be structured into three themes: 1. Influence of the iMCS procedure on patients' live; 2. Effects of iMCS on quality of life and participation and 3. Acceptance and satisfaction. In total, 32% (8/25) were identified as responders, and 68% (17/25) as non-responders. Most patients (71%, 20/28) indicated they would undergo iMCS again. Three patients deceased before the end of the study.</p><p><strong>Conclusion: </strong>This study suggests that the effects of iMCS should be assessed in a more multidimensional way compared to only the effect on pain as patients confided that the true treatment effect and patient satisfaction were based more on improvements of their quality of life, enabling patients to participate again in society in a meaningful way. In clinical practice, this study emphasizes the need for thorough patient education and realistic expectation management prior to implantation, highlighting both potential benefits and limitations to support informed decision-making.</p>","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":"26 3","pages":"e70123"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12930118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147275918","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":"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":"Serratus Anterior Plane Hydrodissection With 5% Dextrose for Refractory Postherpetic Neuralgia.","authors":"Jasmine Kaur, Sonal Kumari, Sujeet Gautam","doi":"10.1111/papr.70149","DOIUrl":"https://doi.org/10.1111/papr.70149","url":null,"abstract":"","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":"26 3","pages":"e70149"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147373029","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}

{"title":"Clinical Practice Variations in Interventional Treatment of Chronic Lumbosacral Radicular Pain Among Registered Dutch Pain Specialists: A National Survey.","authors":"Marius R van Ooijen, Sezai Özkan, Kris C P Vissers, Koen van Boxem, Sandra A S van den Heuvel","doi":"10.1111/papr.70128","DOIUrl":"10.1111/papr.70128","url":null,"abstract":"<p><strong>Objective: </strong>This questionnaire study aims to analyze the current clinical practice of the minimally invasive treatment of chronic lumbosacral radicular pain among accredited pain specialists in the Netherlands.</p><p><strong>Methods: </strong>Participants received an online questionnaire regarding differences in clinical practice comprising definitions and clinical criteria for diagnosis; indications for interventional treatment; technical approaches to treatment; and outcome evaluation in the management of chronic lumbosacral radicular pain.</p><p><strong>Results and conclusion: </strong>A total of 125 pain specialists (response rate: 29%) completed the questionnaire. The most notable finding was that only 27% reported routinely performing prognostic selective nerve root blocks with local anesthetics prior to pulsed radiofrequency (PRF) treatment in patients with chronic lumbosacral radicular pain. Lidocaine was the preferred local anesthetic (n = 72, 63%). PRF was identified as the cornerstone of therapeutic interventional treatment by 81% of respondents (n = 93), and 40% (n = 46) reported combining PRF with corticosteroid administration.</p>","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":"26 3","pages":"e70128"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12926930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271954","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":"Scient Approach (With Ultrasound) to Injecting a Case of Recalcitrant Lateral Epicondylitis.","authors":"Hilmi Berkan Abacıoğlu, Ahmet Furkan Çolak, Levent Özçakar","doi":"10.1111/papr.70137","DOIUrl":"https://doi.org/10.1111/papr.70137","url":null,"abstract":"","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":"26 3","pages":"e70137"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366204","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}