Interventional Pain Medicine最新文献

英文中文

Assessing the availability, readability, and content of online patient Education materials for cancer pain interventions: A cross-sectional analysis of major cancer center websites 评估癌症疼痛干预的在线患者教育材料的可用性、可读性和内容：对主要癌症中心网站的横断面分析

Interventional Pain Medicine

Pub Date : 2025-08-21 DOI: 10.1016/j.inpm.2025.100633

Meha Aggarwal , Marshall Yuan , David Hao

Background

As cancer survival improves, chronic cancer-related pain is an increasing clinical concern. Interventional procedures offer targeted, opioid-sparing pain relief, yet the quality and readability of online educational materials about these options remain poorly understood.

Objective

To evaluate the availability, quality, and readability of online educational resources on interventional cancer pain management available from National Cancer Institute (NCI)-designated cancer centers.

Methods

We conducted a cross-sectional analysis of 65 NCI-designated clinical cancer center websites to identify patient-facing content discussing interventional cancer pain procedures. Eligible materials were evaluated for quality using the DISCERN instrument and for readability using seven validated metrics. Inter-rater reliability was assessed using the intraclass correlation coefficient (ICC). Statistical comparisons were performed using t-tests.

Results

Only 20 of 65 cancer center websites (31%) contained relevant educational materials. Sixty qualifying texts were identified: 28 full articles and 32 substantial mentions (≥50 words). The mean DISCERN score was 37 ± 9, indicating poor quality. Articles scored significantly higher than substantial mentions (mean difference 9.4 points, p < 0.001). The ICC for DISCERN scores was 0.872 (p < 0.001), reflecting good inter-rater agreement. Readability analysis revealed an average reading level equivalent to the 11th grade across all metrics, significantly higher than the NIH-recommended 8th-grade level (p < 0.001). Substantial mentions were significantly more difficult to read than articles (p < 0.001).

Conclusions

Online materials on cancer pain interventions are generally scarce, low in quality, and written above nationally recommended reading levels. These findings highlight the need for cancer centers to improve online education materials using plain language and health literacy tools to better support informed decision-making.

随着癌症生存率的提高，慢性癌症相关疼痛越来越受到临床关注。介入手术提供有针对性的、不使用阿片类药物的疼痛缓解，但关于这些选择的在线教育材料的质量和可读性仍然知之甚少。目的评估美国国家癌症研究所（NCI）指定癌症中心提供的介入性癌症疼痛管理在线教育资源的可得性、质量和可读性。方法：我们对65个nci指定的临床癌症中心网站进行了横断面分析，以确定讨论介入性癌症疼痛手术的面向患者的内容。使用DISCERN仪器评估合格材料的质量，并使用七个经过验证的指标评估材料的可读性。采用类内相关系数（ICC）评估评估间信度。采用t检验进行统计学比较。结果65个癌症中心网站中只有20个（31%）包含相关的教育资料。确定了60篇符合条件的文章：28篇完整文章和32篇实质性提及（≥50字）。平均DISCERN评分为37±9分，表明质量较差。文章得分明显高于大量提及（平均差9.4分，p < 0.001）。DISCERN评分的ICC为0.872 (p < 0.001)，反映了良好的评分间一致性。可读性分析显示，所有指标的平均阅读水平与11年级相当，显著高于美国国立卫生研究院推荐的8年级水平（p < 0.001）。实质性的提及明显比文章更难阅读（p < 0.001）。结论：关于癌症疼痛干预的在线资料普遍稀缺，质量低，且高于国家推荐阅读水平。这些发现强调了癌症中心需要改进在线教育材料，使用简单的语言和健康素养工具，以更好地支持知情决策。

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引用次数: 0

Where are advanced interventional pain procedures happening? 先进的介入性疼痛治疗在哪里进行？

Interventional Pain Medicine

Pub Date : 2025-08-20 DOI: 10.1016/j.inpm.2025.100631

Sandy Christiansen , Rosa Garcia , Daniel A. Jimenez , Shauna Rakshe

Background

An unprecedented volume of interventional procedures has entered the pain medicine market, including many “advanced” interventional pain procedures. Given the rapid influx, there is concern that there is discordance between what is taught in pain medicine fellowship programs and done in post-graduate practice.

Objective

The goal of the study was to compare sales volumes of advanced procedure devices in academic versus non-academic practice settings to better understand the status quo of procedural practice patterns. This information will be critical to establish a baseline understanding of where advanced pain procedures are happening for future comparison.

Methods

This cross-sectional observational study examines relative percentages of industry-reported device sales to academic versus non-academic practices from January 1, 2023 to December 31, 2023 in predefined regions of the United States. The data were tabulated and reported as means with corresponding ranges.

Results

Six companies, representing nine distinct interventional pain procedures, certified the requested data. The region with the lowest relative mean device sales at academic institutions was the West (10 %) and the highest was the Northeast (22 %). The procedure with the lowest relative mean sales at academic institutions was dorsal root ganglion stimulation (4 %) and the highest was vertebral body cooled radiofrequency for bone tumors (30 %).

Conclusion

This study highlights the difference between the relative percentage sales of advanced procedure devices in non-academic versus academic institutions, favoring non-academic sites of service. Yet, for each reported pain procedure, there were device sales in academic settings for almost all regions. It will be essential to continue to monitor how academic procedural training compares to post-graduate practice realities to tailor future educational offerings.

前所未有的介入手术进入了疼痛药物市场，其中包括许多“先进”的介入疼痛手术。鉴于患者的快速涌入，人们担心疼痛医学研究项目中教授的内容与研究生实践中所做的不一致。目的本研究的目的是比较先进的手术器械在学术和非学术实践环境中的销量，以更好地了解手术实践模式的现状。这一信息对于建立了解高级疼痛手术发生位置的基线，以便将来进行比较至关重要。方法：本横断面观察性研究检查了2023年1月1日至2023年12月31日在美国预定义地区，行业报告的设备销售相对于学术和非学术实践的百分比。将数据制成表格，并以相应范围的平均值报告。结果6家公司，代表9种不同的介入性疼痛手术，证实了所要求的数据。学术机构的相对平均设备销售量最低的地区是西部（10%），最高的地区是东北部（22%）。学术机构中相对平均销售额最低的手术是背根神经节刺激（4%），最高的是椎体冷却射频治疗骨肿瘤（30%）。结论本研究突出了先进手术设备在非学术机构和学术机构的相对销售百分比之间的差异，有利于非学术服务场所。然而，对于每一个报告的疼痛手术，几乎所有地区的学术机构都有设备销售。继续监测学术程序培训与研究生实践现实的比较，以定制未来的教育产品，这将是至关重要的。

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引用次数: 0

“Is this injection going to hurt?” Quantifying the pain experience during common lumbosacral spine injections “打针会痛吗？”腰骶椎注射时疼痛体验的量化

Interventional Pain Medicine

Pub Date : 2025-08-20 DOI: 10.1016/j.inpm.2025.100632

Asher Smuek , Rishi Bakshi , Romeo Mays , Lisa Huynh , Joshua Levin , Joshua Rittenberg , Matthew Smuck

Background

“Is this injection going to hurt?” Physicians typically answer this from experience since accurate answers are not available in the literature.

Objective

To quantify pain during common lumbosacral spine injections and compare to baseline pain prior to the injections. Analyze differences based on demographic and procedure variables.

Methods

This is a secondary analysis of prospectively collected data from a multicenter trial of patients undergoing bilateral symmetric transforaminal epidural (TFE), facet joint (FJ), or sacroiliac joint (SIJ) injections. Numeric pain ratings (0-10) were obtained at baseline in preop (“What is your current pain?”) and for each injection procedure (“How much did this injection hurt from start to finish?”) first on the right side then the left. Between group comparisons used Chi-squared and ANOVA for categorical and continuous variables, respectively. T-tests compared various pain responses, and multivariate regression determined factors associated with higher procedure pain.

Results

From 244 injections (124 TFE, 60 FJ, 60 SIJ) on 122 consecutive patients (mean age 57.2, 50 % female), age and BMI did not differ between injection groups while sex did (p = 0.001) with more FJ males and SIJ females. Mean baseline pain was statistically equivalent between demographic and injection groups. Mean procedure pain was consistently higher than mean baseline pain, however this difference was small and non-significant for TFE (4.0 vs 3.8) and FJ (3.9 vs 3.3), but larger and significant for SIJ (5.3 vs. 3.6; p = 0.0001). In the multivariate regression analysis only 2 variables remained associated with higher procedure pain, older age (p < 0.0001) and SIJ injection group (p = 0.0021).

Conclusion

The majority of patients (79.1 %) report mild or moderate pain during common lumbosacral spine injections. The average procedure pain of 4.3 on the NPRS scale was only 0.7 points higher than baseline pain recorded in pre-op. Procedure pain from TFE and FJ injections is statistically equivalent to baseline pain and to each other, while SIJ injections produce higher procedure pain with a significant +1.7 point mean increase in pain from baseline. Finally, older adults report significantly greater procedure pain compared to those under 65 years old.

“打针会痛吗？”医生通常根据经验回答这个问题，因为在文献中没有准确的答案。目的量化普通腰骶椎注射时的疼痛，并与注射前的基线疼痛进行比较。根据人口统计和程序变量分析差异。方法：这是一项前瞻性多中心试验收集的数据的二次分析，这些患者接受双侧对称经椎间孔硬膜外（TFE）、小关节（FJ）或骶髂关节（SIJ）注射。在术前基线时获得数值疼痛评分（0-10）（“你目前的疼痛是什么？”）以及每个注射过程（“从开始到结束，注射有多痛？”）先在右边，然后在左边。组间比较分别对分类变量和连续变量使用卡方和方差分析。t检验比较了各种疼痛反应，多变量回归确定了与较高手术疼痛相关的因素。结果连续122例患者（平均年龄57.2岁，女性占50%）接受244次注射（TFE 124次，FJ 60次，SIJ 60次），注射组间年龄和BMI无差异，性别有差异（p = 0.001）， FJ男性多于SIJ女性。人口统计学组和注射组的平均基线疼痛在统计学上是相等的。平均手术疼痛始终高于平均基线疼痛，然而TFE （4.0 vs 3.8）和FJ （3.9 vs 3.3）的差异很小且不显著，但SIJ的差异更大且显著（5.3 vs 3.6; p = 0.0001）。在多变量回归分析中，只有2个变量与较高的手术疼痛、年龄（p < 0.0001）和SIJ注射组（p = 0.0021）相关。结论：大多数患者（79.1%）报告腰骶椎注射时出现轻度或中度疼痛。NPRS量表的平均手术疼痛为4.3分，仅比术前记录的基线疼痛高0.7分。TFE和FJ注射的手术疼痛在统计学上与基线疼痛相当，并且彼此相等，而SIJ注射产生更高的手术疼痛，疼痛比基线平均增加1.7点。最后，与65岁以下的人相比，老年人报告的手术疼痛明显更大。

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引用次数: 0

Authors' response to the letter to the editor on “Tendon modification with percutaneous ultrasound-guided tenotomy using TENEX®: A histological and macroscopic analysis of a bovine cadaveric model.” 作者对“使用TENEX®经皮超声引导肌腱切开术的肌腱修复：牛尸体模型的组织学和宏观分析”致编辑的信的回复。

Interventional Pain Medicine

Pub Date : 2025-08-15 DOI: 10.1016/j.inpm.2025.100626

Sayed E. Wahezi , Ugur Yener , Suwannika Palee

引用次数: 0

Reassessing the risks of Cervical Transforaminal Epidural Steroid Injections (CTFESI) 宫颈经椎间孔硬膜外类固醇注射（CTFESI）的风险评估

Interventional Pain Medicine

Pub Date : 2025-08-15 DOI: 10.1016/j.inpm.2025.100625

Clark C. Smith MD, MPH

引用次数: 0

Safety and effectiveness of basivertebral nerve ablation in patients with osteoporosis and osteopenia: A real-world study 椎体神经消融治疗骨质疏松和骨质减少患者的安全性和有效性：一项真实世界的研究

Interventional Pain Medicine

Pub Date : 2025-08-14 DOI: 10.1016/j.inpm.2025.100624

Emily Bellow, Derek Johnson, Sandi Bajrami, William Caldwell

Background

The Intracept procedure was the first FDA-cleared technique for basivertebral nerve ablation, a minimally invasive treatment for vertebrogenic chronic low back pain. While prior studies support its effectiveness, data in patients with osteoporosis and osteopenia remains limited.

Objective

To evaluate the safety and effectiveness of basivertebral nerve ablation with a specific focus on pain reduction, functional improvement, and the incidence of post-procedure vertebral compression fractures.

Methods

A retrospective chart review was conducted on patients who underwent the Intracept procedure at our institution from November 2019 to January 2025. Bone density status was categorized using available DEXA scans. Patients were stratified into a Reduced Bone Density group (N = 32), consisting of 23 patients with osteopenia and 9 with osteoporosis, and the overall cohort (N = 134). Pain severity was assessed using the Visual Analog Scale (VAS) at baseline and at the 4–6-week post-procedure follow-up visit, and functional improvement was determined based on patient-reported outcomes at the same time point. Post-procedure complications, including vertebral compression fractures, were monitored until the most recent available follow-up.

Results

A significant decrease in VAS was observed for the overall cohort (7.04 vs. 3.78, p < 0.001) and the Reduced Bone Density group (6.75 vs. 4.13, p < 0.001). Functional improvement was reported by 79.1 % of patients in the overall study population and 78.1 % of patients in the Reduced Bone Density group. No post-procedure vertebral compression fractures were observed in the entire cohort, with a mean follow-up length of 18.07 months.

Conclusion

The Intracept procedure demonstrated significant pain reduction and functional improvement in the overall cohort and in patients with reduced bone density. Notably, no post-procedure vertebral compression fractures were observed, even in patients with osteoporosis and osteopenia. These findings contribute to the growing body of independent literature supporting the safety and effectiveness of the Intracept procedure and offer real-world insight into its use in patients with reduced bone density.

背景：该手术是首个获得fda批准的椎体神经消融技术，是一种治疗椎体源性慢性腰痛的微创治疗方法。虽然先前的研究支持其有效性，但骨质疏松症和骨质减少患者的数据仍然有限。目的评价基椎神经消融术的安全性和有效性，特别关注疼痛减轻、功能改善和术后椎体压缩性骨折的发生率。方法回顾性分析2019年11月至2025年1月在我院行内置管术的患者。使用DEXA扫描对骨密度状态进行分类。将患者分层分为骨密度降低组（N = 32），其中骨质减少组23例，骨质疏松组9例，整体队列（N = 134）。在基线和术后4 - 6周随访时使用视觉模拟量表（VAS）评估疼痛严重程度，并根据患者报告的同一时间点的结果确定功能改善情况。术后并发症，包括椎体压缩性骨折，一直监测到最近的随访。结果整个队列的VAS评分显著下降(7.04 vs. 3.78, p <；0.001)和骨密度降低组(6.75 vs. 4.13, p <；0.001)。总体研究人群中79.1%的患者和骨密度降低组中78.1%的患者报告功能改善。整个队列中未观察到术后椎体压缩性骨折，平均随访时间为18.07个月。结论：在整个队列和骨密度降低的患者中，截骨术显示出明显的疼痛减轻和功能改善。值得注意的是，即使在骨质疏松和骨质减少的患者中，也没有观察到术后椎体压缩性骨折。这些发现有助于越来越多的独立文献支持内截骨术的安全性和有效性，并为其在骨密度降低患者中的应用提供了真实的见解。

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引用次数: 0

Perioperative considerations for peripheral nerve stimulation devices: A practical guide 周围神经刺激装置围手术期注意事项：实用指南

Interventional Pain Medicine

Pub Date : 2025-08-11 DOI: 10.1016/j.inpm.2025.100628

Stefani M. Schwartz MD, David Hao MD

引用次数: 0

Regenerating the epidural space: Promise and perspective on amniotic fluid for low back pain. 硬膜外腔再生：羊水治疗腰痛的前景与展望。

Interventional Pain Medicine

Pub Date : 2025-08-08 eCollection Date: 2025-09-01 DOI: 10.1016/j.inpm.2025.100627

Alexandre J Bourcier, Zbigniew M Kirkor

引用次数: 0

Concerns regarding Palee et al. and reasserting the underlying mechanism of action in percutaneous tenotomy. 对Palee等人的关注，并重申经皮肌腱切开术的潜在作用机制。

Interventional Pain Medicine

Pub Date : 2025-08-07 eCollection Date: 2025-09-01 DOI: 10.1016/j.inpm.2025.100619

Walter I Sussman, Mederic Hall, Brennan J Boettcher

引用次数: 0

Letter to the Editor regarding “Assessing ChatGPT responses to patient questions on epidural steroid injections” 致编辑关于“评估ChatGPT对患者硬膜外类固醇注射问题的反应”的信

Interventional Pain Medicine

Pub Date : 2025-08-02 DOI: 10.1016/j.inpm.2025.100620

Hinpetch Daungsupawong , Viroj Wiwanitkit

引用次数: 0

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