Interventional Pain Medicine最新文献

{"title":"Rates of lumbar vertebral body compression fracture after basivertebral nerve ablation: A retrospective study utilizing a large national database","authors":"Justin Chau ,&nbsp;Durga Ghosh ,&nbsp;Sean Fox ,&nbsp;Ayahiro D. Takashima ,&nbsp;Andrew Stephens","doi":"10.1016/j.inpm.2025.100654","DOIUrl":"10.1016/j.inpm.2025.100654","url":null,"abstract":"<div><h3>Background</h3><div>Basivertebral nerve ablation (BVNA) is an effective treatment for vertebrogenic chronic low back pain. However, data regarding rates of post-BVNA lumbar vertebral compression fracture (VCF), particularly among patients with osteoporosis or osteopenia, remains limited.</div></div><div><h3>Objective</h3><div>(1) Estimate the rate of lumbar VCF after BVNA. (2) Compare rates between patients with and without a pre-BVNA diagnosis of osteopenia/osteoporosis utilizing a large global database.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was performed using TriNetX, a national database of de-identified health records from over 130 million patients. Adults (≥18 years) who underwent BVNA between January 2022 and August 2025 were identified via CPT code. Patients were stratified by presence or absence of ICD-10 code for osteoporosis/osteopenia before undergoing BVNA. The primary outcome was incidence of ICD-10 code diagnosis of lumbar VCF after undergoing BVNA.</div></div><div><h3>Results</h3><div>A total of 2387 patients underwent BVNA (mean age 63.7 years; 48.0 % female). Of these, 669 had a pre-BVNA diagnosis of osteoporosis/osteopenia (mean age 70.2 ± 10.7 years; 64.4 % female). Lumbar VCF occurred in 37 patients (1.55 %; 95 % CI, 1.11–2.16 %) after BVNA. Patients with osteoporosis/osteopenia had higher rate of post-BVNA lumbar VCF compared to those without (4.64 % vs 0.37 %), though rates of post-BVNA lumbar VCF were overall low across all patients (1.55 %). Osteoporosis/osteopenia was independently associated with post-BVNA VCF (adjusted OR 6.5; 95 % CI, 3.7–12.3; p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>While patients with pre-BVNA ICD-10 code diagnosis of osteoporosis/osteopenia had higher rates and were at higher risk of post-BVNA VCF than those without, overall rates were still low. Risk of VCF should be considered and risks/benefits should be discussed with patients, but a diagnosis of osteoporosis/osteopenia should not be considered an absolute contraindication to BVNA.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 4","pages":"Article 100654"},"PeriodicalIF":0.0,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rates of cervical spine surgery and repeat epidural injections after cervical transforaminal epidural steroid injections for patients with cervical radiculopathy utilizing a large national database","authors":"Andrew R. Stephens ,&nbsp;Ramzi El-Hassan ,&nbsp;Ashley Rogerson","doi":"10.1016/j.inpm.2025.100651","DOIUrl":"10.1016/j.inpm.2025.100651","url":null,"abstract":"<div><h3>Background</h3><div>Cervical transforaminal epidural steroid injections (CTFESI) are commonly performed to treat cervical radicular pain and decrease the need of surgery. The literature is mixed regarding the efficacy of CTFESI in obviating the need for cervical spine surgery.</div></div><div><h3>Objective</h3><div>The purpose of this study was to assess the rates of cervical spine surgery and spinal interventions after initial CTFESI for patients with radicular pain.</div></div><div><h3>Methods</h3><div>TriNetX, a large national database, was queried from 2004 to 2025 for patients who underwent CTFESI for cervical radiculopathy. The rates of treatment progression after initial CTFESI were calculated. Treatment progression included: no additional treatment, repeat CTFEI, cervical interlaminar epidural steroid injection (CIESI), and cervical spine surgery. Cervical spine surgeries analyzed included anterior cervical decompression and fusion (ACDF), foraminotomy, and total disc replacement (TDR). Treatment rates were also calculated for patients after a second CTFESI.</div></div><div><h3>Results</h3><div>There were 28,345 patients who underwent CTFESI during this study period. After initial CTFESI, 57 % of patients did not undergo any additional procedures/surgeries, 23.7 % had a repeat CTFESI, 5.6 % received a CILESI, 7.4 % underwent ACDF, 1.6 % underwent a foraminotomy, and 1.8 % underwent a TDR. Together, after initial CTFESI, 10.8 % of patients went on to cervical spine surgery as a second line treatment. Of the 6,711 patients who received a repeat CTFESI, 74.5 % had no additional interventional treatment, 8.2 % underwent a CIESI, 10.6 % underwent ACDF, 2.5 % underwent a foraminotomy, and 2.2 % underwent a TDR. In total, 15.3 % of patients underwent cervical spine surgery after a second CTFESI. A third consecutive CTFESI was not attempted in any patients.</div></div><div><h3>Conclusion</h3><div>This study demonstrates rates of surgery after an initial CTFESI and a repeat CTFEIS to be low.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 4","pages":"Article 100651"},"PeriodicalIF":0.0,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness of thoracic medial branch radiofrequency ablation using a three-tined electrode: A real-world cross-sectional cohort study","authors":"Hasan Sen ,&nbsp;Edvin Koshi ,&nbsp;Matthew Essman ,&nbsp;Amanda N. Cooper ,&nbsp;Audrey Adler ,&nbsp;Akbar Nabi ,&nbsp;Blake Dickenson ,&nbsp;William Tang ,&nbsp;Chase Young ,&nbsp;Taylor Burnham ,&nbsp;Alexandra E. Fogarty ,&nbsp;Allison Glinka Przybysz ,&nbsp;Aaron M. Conger ,&nbsp;Zachary L. McCormick","doi":"10.1016/j.inpm.2025.100649","DOIUrl":"10.1016/j.inpm.2025.100649","url":null,"abstract":"<div><h3>Background</h3><div>Thoracic medial branch radiofrequency ablation (TMBRFA) is used to treat chronic thoracic spine pain, but data regarding its effectiveness and technique remain limited.</div></div><div><h3>Objectives</h3><div>Evaluate outcomes of TMBRFA using a three-tined electrode in patients with thoracic facet joint pain.</div></div><div><h3>Methods</h3><div>Consecutive patients who underwent first-time TMBRFA at a single tertiary academic center between 2022 and 2024 were identified and contacted for follow-up via standardized telephone survey at ≥6 months post-procedure. Baseline demographic and clinical data were extracted from electronic medical records. Outcomes included the proportions of patients with ≥50% numerical rating scale (NRS) pain score reduction, ≥2-point NRS reduction, and Patient Global Impression of Change (PGIC) scores ≥6 (indicating at least “much improved”). Mean NRS pain score reduction and changes in opioid use from baseline were also assessed.</div></div><div><h3>Results</h3><div>Outcomes were successfully collected from 11 patients. At a mean follow-up of 20.6 ± 7.6 months, 36.4% (95%CI: 15.2–64.6) and 45.5% (95%CI: 21.3–72.0) of patients reported ≥50% and ≥2-point NRS reductions, respectively, with 54.6% (95%CI: 28.0–78.7) reporting PGIC scores ≥6. Mean NRS pain score reduction was 1.9 ± 2.7 points. Two patients had ceased using opioids at follow-up, representing a proportional decrease of 18.2% compared to baseline.</div></div><div><h3>Conclusion</h3><div>In this cohort, approximately half of patients who underwent first-time TMBRFA with a three-tined electrode experienced clinically meaningful pain relief and perceived overall improvement at an average follow-up of nearly 2 years. Larger, prospective studies are needed to corroborate these findings.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 4","pages":"Article 100649"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative considerations for spinal cord stimulation devices: A practical guide","authors":"Dorsa Kavandi ,&nbsp;Eileen T. Jin ,&nbsp;Salim M. Hayek ,&nbsp;David Hao","doi":"10.1016/j.inpm.2025.100648","DOIUrl":"10.1016/j.inpm.2025.100648","url":null,"abstract":"","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 4","pages":"Article 100648"},"PeriodicalIF":0.0,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective review of outcomes in patients with Bertolotti's syndrome who underwent fluoroscopically-guided pseudojoint injections","authors":"Rachel Pooley ,&nbsp;Adam Delora ,&nbsp;Mingda Chen ,&nbsp;Muhammad T. Amjad ,&nbsp;Nicolas R. Thompson ,&nbsp;Kush K. Goyal","doi":"10.1016/j.inpm.2025.100647","DOIUrl":"10.1016/j.inpm.2025.100647","url":null,"abstract":"<div><h3>Introduction</h3><div>A lumbosacral transitional vertebra (LSTV) is an articulation or fusion of the transverse process of the fifth lumbar vertebra and the sacrum or ilium, and, when associated with pain, it is referred to as Bertolotti's syndrome. Few studies have examined the diagnostic utility of LSTV injections and their ability to provide relief in cases of Bertolotti's syndrome. In this study, we investigate predictors of positive clinical outcomes following LSTV injection and examine the relationship between a positive diagnostic injection and outcomes after LSTV resection in patients with Bertolotti's syndrome.</div></div><div><h3>Methods</h3><div>This study was a retrospective analysis of 56 patients from September 2013 through August 2024 who were diagnosed with Bertolotti's syndrome and who had received a pseudojoint injection with a steroid and an anesthetic. Demographic information, comorbid conditions, and information about pain and multiple validated outcomes were extracted from the electronic health record.</div></div><div><h3>Results</h3><div>The patients had a mean age of 44 years, and 62.5 % (35/56) of the patients were female. Lumbar spondylolisthesis was found in 20.0 % of patients (11/55). Using the Castellvi classification, the most common type of LSTV was Type 2a (42/56, 75.0 %). Of the patients, 55.4 % had an anxiety disorder (N = 31/56) and 42.9 % had depression (24/56). Numeric rating scale (NRS) scores significantly improved from preprocedure to immediate postprocedure (P &lt; 0.001), with 39/45 (86.7 %) achieving a minimal clinically important difference (MCID) of 2.5, and from preprocedure to follow-up (P &lt; 0.001), with 8/25 (32.0 %) achieving an MCID of 2.5. The median duration of pain relief was 14 days. There was no statistically significant difference in PROMIS-GH physical and mental scores, and no difference in PHQ-9 in patients between preprocedure and follow-up. Patients with a higher American Society of Anesthesiologists (ASA) physical status classification were less likely to experience relief (p = 0.025). Additionally, patients who received an injection of Triamcinolone (p = 0.018) were less likely to experience relief at follow-up than those who received methylprednisolone, although this difference was not observed immediately after injection. Only 13 patients underwent a resection of the pseudojoint, of which 8 (61.5 %) reported improvement after resection.</div></div><div><h3>Discussion</h3><div>Injections into the pseudojoint under fluoroscopic guidance may provide therapeutic benefits and may have some diagnostic impact on surgical intervention. Future randomized prospective research should be performed to determine the appropriate utilization of pseudojoint injections and create an evidence-based diagnostic and therapeutic algorithm to isolate pain generators in Bertolotti's syndrome and create an appropriate individualized treatment.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 4","pages":"Article 100647"},"PeriodicalIF":0.0,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145363877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided genicular nerve radiofrequency ablation: A revised protocol illustrated through high-definition video","authors":"Tomás Caroço ,&nbsp;Giovanni Leoni ,&nbsp;Daniela Teixeira ,&nbsp;Jorge Ribeiro ,&nbsp;Bruno Paiva ,&nbsp;Jorge Barbosa","doi":"10.1016/j.inpm.2025.100643","DOIUrl":"10.1016/j.inpm.2025.100643","url":null,"abstract":"<div><h3>Background</h3><div>Radiofrequency ablation (RFA) of the knee joint may be an effective therapeutic option for the management of chronic knee pain. Accurate anatomical knowledge is essential for optimizing the precision and outcomes of the procedure. The innervation of the knee joint is complex. Ultrasound (US) guidance offers a widely accessible method for targeting sensory nerves. Given the limited availability of high-quality video literature on knee RFA, we developed an educational video illustrating an extensive revised ultrasound-guided protocol.</div></div><div><h3>Objective</h3><div>To present a video-based description of a revised ultrasound-guided RFA protocol for the knee, targeting specific nerves by anatomical quadrant: superomedial quadrant (Video 1)– medial branch of the NVI, SMGN; inferomedial quadrant (Video 2) – IMGN; superolateral quadrant (Video 3) – lateral branch of the NVI, SLGN; and inferolateral quadrant (Video 4) - RFN.</div></div><div><h3>Methods</h3><div>Seven patients with advanced knee osteoarthritis, unresponsive to conservative treatment, underwent selective RFA of either the medial or lateral quadrants, based on the distribution of their pain. The procedures were recorded in high definition and annotated to serve educational purposes.</div></div><div><h3>Conclusions</h3><div>The video-based illustrations presented may enhance procedural clarity and facilitate clinician training. Due to the time consuming and potential for pain associated with the procedure described, targeting all nerves may be not appropriate in every patient. An individualized approach, tailoring the selection of targets based on patient-specific characteristics and localization of pain is likely more optimal.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 4","pages":"Article 100643"},"PeriodicalIF":0.0,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145334049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluoroscopy-guided celiac plexus block – Trans-Aortic approach","authors":"Kelly Li ,&nbsp;Ivy Liu ,&nbsp;Robert Jason Yong ,&nbsp;David Hao","doi":"10.1016/j.inpm.2025.100644","DOIUrl":"10.1016/j.inpm.2025.100644","url":null,"abstract":"<div><div>Transaortic celiac plexus block is an image-guided procedure used to manage refractory abdominal pain, often related to malignancy or chronic conditions like pancreatitis. This educational video demonstrates the transaortic approach for celiac plexus block under fluoroscopic guidance. The video reviews indications, relevant anatomy, procedural steps, and potential complications. This content is intended to supplement formal instruction and enhance understanding of a targeted technique used in the management of abdominal pain.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 4","pages":"Article 100644"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145270421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-articular cervical facet joint corticosteroid injections in patients with increased peri-facet MRI STIR signal. A prospective, multi-center case series","authors":"Joshua Levin ,&nbsp;Kevin Barrette ,&nbsp;Cyrus Ghaffari ,&nbsp;Reza Ehsanian ,&nbsp;Jayme Koltsov ,&nbsp;Christina Giacomazzi ,&nbsp;Nitin Prabhakar ,&nbsp;Lisa Huynh ,&nbsp;Matthew Smuck ,&nbsp;William Summers ,&nbsp;Byron Schneider","doi":"10.1016/j.inpm.2025.100646","DOIUrl":"10.1016/j.inpm.2025.100646","url":null,"abstract":"<div><h3>Background</h3><div>Intra-articular cervical facet joint corticosteroid injections are commonly performed, yet studies demonstrating benefit are limited.</div></div><div><h3>Purpose</h3><div>To evaluate success rates of intra-articular cervical facet joint corticosteroid injections in patients with increased peri-facet edema as demonstrated by MRI with STIR sequences.</div></div><div><h3>Study design</h3><div>Preliminary, prospective, multi-center case series.</div></div><div><h3>Patient sample</h3><div>Thirty-three patients from three independent spine centers.</div></div><div><h3>Methods</h3><div>Consecutive patients were enrolled with axial neck pain and peri-facet joint edema on MRI with STIR sequences when undergoing intra-articular cervical facet joint corticosteroid injections. Outcomes were prospectively collected at 2-4-weeks and at 3-months post-injection. The primary outcome was the proportion of patients with at least 50 % improvement in the numeric rating scale (NRS) pain score. Neck disability index (NDI) and global perception of change (GPC) were evaluated as secondary outcomes.</div></div><div><h3>Results</h3><div>At 2-4-weeks post-injection, 64 % [95 %CI: 46–79 %] of the 28 patients with follow-up data met criteria for success (≥50 % improvement in NRS). 86 % [95 %CI: 69–94 %] reported that they were better or much better on the GPC, and mean NDI improved from 19.3 to 8.9. At 3-months post-injection, 35 % [95 %CI: 19–54 %] of the 26 patients with follow-up data met criteria for success, and 50 % [95 %CI: 32–68 %] reported that they were better or much better on the GPC. Mean NDI at 3-months was 11.0.</div></div><div><h3>Conclusions</h3><div>Intra-articular cervical facet joint corticosteroid injections may provide short-term relief of neck pain in patients with peri-facet edema as demonstrated by MRI with STIR sequences. Intermediate-term results are less encouraging.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 4","pages":"Article 100646"},"PeriodicalIF":0.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145270422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-reported outcomes following radiofrequency ablation of the hip: a retrospective study","authors":"Melissa Schwartz ,&nbsp;Alejandra Cardenas-Rojas ,&nbsp;Michael Suarez ,&nbsp;Anna Megenhardt ,&nbsp;Ahmed Khawer ,&nbsp;Annie Yang ,&nbsp;Eric Muneio ,&nbsp;Pranamya Suri ,&nbsp;Akhil Chhatre","doi":"10.1016/j.inpm.2025.100645","DOIUrl":"10.1016/j.inpm.2025.100645","url":null,"abstract":"<div><h3>Background</h3><div>Chronic hip pain, primarily caused by osteoarthritis, is a prevalent condition that significantly reduces quality of life for many individuals. Radiofrequency ablation (RFA) has emerged as a promising, minimally invasive treatment targeting sensory nerves around the hip joint to provide sustained relief. However, guidelines for selecting suitable patients and predicting outcomes remain unclear.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate patient-reported pain outcomes following hip RFA and to identify pre-procedure patient factors influencing treatment response.</div></div><div><h3>Methods</h3><div>In this retrospective study conducted at a tertiary academic center, data was collected from patients undergoing unilateral or bilateral RFA of the articular branches of the obturator and femoral nerves between August 2019 and August 2024. Information collected included demographics, osteoarthritis severity, opioid and antidepressant use, and pre- and post-procedure numeric rating scale (NRS) scores for pain. Primary outcome measures were pre-post difference NRS score, considering clinically meaningful a ≥2-point improvement in NRS and ≥50 % pain reduction. Secondary outcomes included patient perceptions measured using the Patient Global Impression of Change (PGIC) scale. Logistic regression analysis was conducted to identify predictors of treatment success.</div></div><div><h3>Results</h3><div>Fifty-four patients (64 procedures) participated, predominantly female (64.8 %), with an average age of 68 years old and BMI of 31.43 kg/m². A significant median reduction of 2.5 points in NRS was reported post-procedure (p &lt; 0.001). Overall, 56.25 % of patients achieved a clinically meaningful ≥2-point NRS reduction, and 43.75 % experienced ≥50 % pain reduction. Approximately 66 % of patients reported improvement on the PGIC scale. The average duration of pain relief among responders was six months. Patients without pre-procedure opioid use (OR = 0.24, p = 0.027) and those with higher BMI (p = 0.04) had significantly better outcomes.</div></div><div><h3>Conclusion</h3><div>Hip RFA demonstrates potential in reducing pain levels and improving patient-reported outcomes in individuals with chronic hip pain. Better outcomes were notably associated with the absence of pre-procedure opioid use and higher BMI. Further research is needed to refine patient selection guidelines and to evaluate functional improvements following the procedure.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 4","pages":"Article 100645"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145196029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"True AP imaging during lumbar medial branch radiofrequency neurotomy: Interobserver reliability","authors":"Patrick H. Waring ,&nbsp;W. Evan Rivers ,&nbsp;Duncan L. Bralts ,&nbsp;D. Keith Granger II ,&nbsp;Timothy P. Maus ,&nbsp;Belinda Duszynski ,&nbsp;Michael B. Furman","doi":"10.1016/j.inpm.2025.100630","DOIUrl":"10.1016/j.inpm.2025.100630","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;True segmental imaging, in AP and lateral planes, is necessary to accurately place an RF cannula contiguous with the targeted medial branch and achieve effective pain relief with lumbar radiofrequency neurotomy (LMBRFN). True lateral imaging and its interobserver reliability during LMBRFN have been described. A complementary true AP imaging technique has recently been described, but its interobserver reliability has yet to be studied.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This study aims to determine the interobserver reliability of the recently described true AP imaging technique for LMBRFN.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;After obtaining IRB exemption, true and untrue AP images were collected from consecutive LMBRFN procedures performed during the normal course of the primary author's (PW) practice. A 100-slide testing set was formulated. Each slide contained a true and an untrue counterpart AP image depicting the same single-level RF cannula placement targeting an L3 or L4 medial branch or an L5 dorsal ramus. After slide randomization, a Google Forms test was created to capture observer responses. Two sets of observers were used to represent novice (DB,KG) and experienced (MF,ER) observers. Each observer independently reviewed the testing slide set, recording a total of 300 responses for the three binary decisions on each slide: which image was true, which corrective maneuver (oblique or tilt) was required to make the untrue image a true image, and finally, which was the direction of the appropriate corrective maneuver (right or left oblique/cranial or caudal tilt). Each observer's test was compared to the answer key established by two non-observer authors (PW,TM). Interobserver agreement for both the novice and experienced groups was determined for each of the three decisions using the Kappa score calculation. Individual observer performance was also determined.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;For the determination of the true image, the novice group's interobserver agreement (Kappa score) was 0.98 (0.94,1.0); the experienced group's was 0.96 (0.91,1.0). For the oblique or tilt corrective maneuver decision, the novice group's Kappa was 1.0; the experienced group's was 0.98 (0.94,1.0). For the direction of the oblique corrective maneuver, the novice group's Kappa was 1.0; the experienced group's was 0.88 (0.75,1.0). For the direction of the tilt corrective maneuver, the novice group's Kappa was 0.96 (0.88,1.0); the experienced group's was 0.92 (0.81,1.0). Individual observer performance data on the total of 300 decisions ranged from 98% (an experienced observer) to 100% (a novice observer).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Obtaining true AP imaging for LMBRFN by the newly described technique is supported by significant interobserver reliability that ranges from substantial to perfect. This AP imaging technique, when combined with true lateral imaging, provides true lumbar segmental imaging. True ","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 3","pages":"Article 100630"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}