{"title":"In Response to: Request for Withdrawal of Publication of \"Rapid Recommendations by Busse et al of Commonly Used Interventional Procedures for Non-Cancer Chronic Spine Pain: A Clinical Practice Guidelines\".","authors":"Helen Macdonald","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 S7","pages":"S219"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145892636","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}
Olivier Clerk-Lamalice, Alfonso Spath, Kimberly Carcary, Kasra Amirdelfan, Pierce D Nunley, Douglas P Beall
<p><strong>Background: </strong>Degenerative disc disease (DDD) is the most common cause of chronic low back pain (CLBP). In DDD, proteoglycans within the nucleus pulposus break down and lose their ability to retain water, thereby reducing the volume of intervertebral discs and decreasing their weight-bearing capacity. Mechanical loading shifts to the annulus fibrosus, creating fissures and tears that leak crucial factors in the pain to cascade into the intradiscal space and trigger inflammation. When conventional treatments for CLBP fail, surgical options may be required. These surgeries carry risks and require months to heal. For intervertebral discs requiring augmentation, an implant in the form of an injectable, polymer-based hydrogel was developed for the percutaneous treatment of CLBP secondary to lumbar DDD. We hypothesize that the implant's hydrophilic properties will increase water retention and hydration, improve biomechanics, distribute axial loading more evenly across the annulus fibrosus, and reduce some mechanical sources of discogenic disc pain.</p><p><strong>Objective: </strong>To evaluate the safety and efficacy of a novel, injectable hydrogel implant for the treatment of CLBP.</p><p><strong>Study design: </strong>Prospective, single-arm, multicenter feasibility and safety study.</p><p><strong>Methods: </strong>Patients with CLBP lasting for longer than 6 months, DDD (modified Pfirrmann grades 4-8), competent outer annuli, numeric rating scale (NRS) scores >= 4, and Oswestry Disability Index (ODI) scores >= 30 were enrolled in 3 outpatient clinics in Canada and Colombia. The hydrogel implant, melted and equilibrated to 65°C, was injected intradiscally with a 17G needle under local anesthesia, using fluoroscopic guidance. The hydrogel cooled to approximately 42°C as it exited the needle directly into the nucleus. Patients were discharged that day. Clinical assessments included ODI and NRS (taken at one, 3, 6, and 12 months), radiographs, computed tomography, and magnetic resonance imaging (MRI) scans. The primary outcome was the successful insertion of the implant in a lumbar disc nucleus.</p><p><strong>Results: </strong>Sixty patients (36 women, 24 men), 49.0 ± 9.3 years old, received 83 implants (one disc-level: n = 37; 2 disc-levels: n = 23). All patients were implanted successfully without complications during the procedure or at discharge. One patient died (for reasons unrelated to the device/procedure), and one patient was lost to follow-up, for n = 58 at the 12-month follow-up. Five patients (8.6%) experienced increased low back pain (LBP) or leg pain and/or leg paresthesia, due to what radiological procedures confirmed was partial implant migration. Migrated implant portions were removed endoscopically from those patients 2 weeks to 10 months after implantation, constituting a 6% (5/83) failure rate. Mean (standard error [SE]) ODI scores in the patients was 9.6 (1.7) at the final follow-up. In the full cohort, ODI scores
{"title":"Feasibility and Safety of Treatment of Painful Lumbar Degenerative Disc Disease with an Injectable Hydrogel Implant at One-year Follow-up.","authors":"Olivier Clerk-Lamalice, Alfonso Spath, Kimberly Carcary, Kasra Amirdelfan, Pierce D Nunley, Douglas P Beall","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Degenerative disc disease (DDD) is the most common cause of chronic low back pain (CLBP). In DDD, proteoglycans within the nucleus pulposus break down and lose their ability to retain water, thereby reducing the volume of intervertebral discs and decreasing their weight-bearing capacity. Mechanical loading shifts to the annulus fibrosus, creating fissures and tears that leak crucial factors in the pain to cascade into the intradiscal space and trigger inflammation. When conventional treatments for CLBP fail, surgical options may be required. These surgeries carry risks and require months to heal. For intervertebral discs requiring augmentation, an implant in the form of an injectable, polymer-based hydrogel was developed for the percutaneous treatment of CLBP secondary to lumbar DDD. We hypothesize that the implant's hydrophilic properties will increase water retention and hydration, improve biomechanics, distribute axial loading more evenly across the annulus fibrosus, and reduce some mechanical sources of discogenic disc pain.</p><p><strong>Objective: </strong>To evaluate the safety and efficacy of a novel, injectable hydrogel implant for the treatment of CLBP.</p><p><strong>Study design: </strong>Prospective, single-arm, multicenter feasibility and safety study.</p><p><strong>Methods: </strong>Patients with CLBP lasting for longer than 6 months, DDD (modified Pfirrmann grades 4-8), competent outer annuli, numeric rating scale (NRS) scores >= 4, and Oswestry Disability Index (ODI) scores >= 30 were enrolled in 3 outpatient clinics in Canada and Colombia. The hydrogel implant, melted and equilibrated to 65°C, was injected intradiscally with a 17G needle under local anesthesia, using fluoroscopic guidance. The hydrogel cooled to approximately 42°C as it exited the needle directly into the nucleus. Patients were discharged that day. Clinical assessments included ODI and NRS (taken at one, 3, 6, and 12 months), radiographs, computed tomography, and magnetic resonance imaging (MRI) scans. The primary outcome was the successful insertion of the implant in a lumbar disc nucleus.</p><p><strong>Results: </strong>Sixty patients (36 women, 24 men), 49.0 ± 9.3 years old, received 83 implants (one disc-level: n = 37; 2 disc-levels: n = 23). All patients were implanted successfully without complications during the procedure or at discharge. One patient died (for reasons unrelated to the device/procedure), and one patient was lost to follow-up, for n = 58 at the 12-month follow-up. Five patients (8.6%) experienced increased low back pain (LBP) or leg pain and/or leg paresthesia, due to what radiological procedures confirmed was partial implant migration. Migrated implant portions were removed endoscopically from those patients 2 weeks to 10 months after implantation, constituting a 6% (5/83) failure rate. Mean (standard error [SE]) ODI scores in the patients was 9.6 (1.7) at the final follow-up. In the full cohort, ODI scores ","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 S7","pages":"S203-S213"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893196","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":"Request for Withdrawal of Publication of \"Rapid Recommendations by Busse et al of Commonly Used Interventional Procedures for Non-Cancer Chronic Spine Pain: A Clinical Practice Guidelines\".","authors":"Laxmaiah Manchikanti","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 S7","pages":"S215-S218"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145892866","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}
Annu Navani, Swarnima Vardhan, Abhinav Aggarwal, Riya Navani, Jose Fabio Lana, Sudhir A Diwan
<p><strong>Background: </strong>Low back pain (LBP) is a common and complex health issue with a multifactorial origin, involving structures such as the lumbar intervertebral discs (IVDs), facet joints, muscles, ligaments, and nerve roots. Typically, traditional pain management approaches target isolated pain generators. However, recent advancements, particularly regenerative injection techniques, have shifted the focus toward a more comprehensive treatment model that addresses the entire functional spinal unit (FSU), providing a disease-modifying approach.</p><p><strong>Objectives: </strong>The purpose of this narrative review is to provide a scoping overview of the concept of the FSU and evaluate the potential role of orthobiologics, such as platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs), in treating back pain associated with various spinal conditions.</p><p><strong>Study design: </strong>Narrative literature review.</p><p><strong>Methods: </strong>Relevant peer-reviewed manuscripts were identified through a comprehensive search of electronic databases, such as PubMed, Embase, and Google Scholar. Studies focusing on the anatomy, biomechanics, and pathology of the FSU, as well as those concerning the application of PRP and MSCs in spinal disorders, were included.</p><p><strong>Results: </strong>The FSU, the smallest structural unit of the spine, consists of 2 vertebrae, an IVD, facet joints, and associated supporting ligaments. The FSU is crucial for absorbing shock, distributing mechanical loads, protecting the spinal cord and nerve roots, and maintaining spinal stability and mobility. Orthobiologic therapies, including PRP and MSCs, have shown promise in modulating disease processes and promoting tissue repair in spinal conditions. Emerging evidence supports the efficacy of these therapies in reducing pain and improving functional outcomes by targeting multiple components of the FSU. A thorough understanding of the biomechanical processes and the dynamic distribution of mechanical load across its various structures is essential to recognizing that chronic LBP often arises from multiple pain generators rather than a single source. Therefore, an integrated treatment approach that addresses these multiple pain generators collectively, considering the FSU and the entire spine, is critical for optimizing patient outcomes.</p><p><strong>Limitations: </strong>Rather than being systematic, this narrative review is focused on providing an overview of the effects of orthobiologics in the treatment of chronic LBP using an FSU approach. The heterogeneity of study designs, variability in treatment protocols, and limited long-term data pose challenges in establishing standardized guidelines for orthobiologic therapies in LBP management.</p><p><strong>Conclusions: </strong>Orthobiologic treatments offer a promising disease-modifying approach by addressing the entire FSU rather than isolated pain generators. Future research should focus on optimi
{"title":"Functional Spinal Unit Approach for Orthobiologic Injections for Low Back Pain.","authors":"Annu Navani, Swarnima Vardhan, Abhinav Aggarwal, Riya Navani, Jose Fabio Lana, Sudhir A Diwan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Low back pain (LBP) is a common and complex health issue with a multifactorial origin, involving structures such as the lumbar intervertebral discs (IVDs), facet joints, muscles, ligaments, and nerve roots. Typically, traditional pain management approaches target isolated pain generators. However, recent advancements, particularly regenerative injection techniques, have shifted the focus toward a more comprehensive treatment model that addresses the entire functional spinal unit (FSU), providing a disease-modifying approach.</p><p><strong>Objectives: </strong>The purpose of this narrative review is to provide a scoping overview of the concept of the FSU and evaluate the potential role of orthobiologics, such as platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs), in treating back pain associated with various spinal conditions.</p><p><strong>Study design: </strong>Narrative literature review.</p><p><strong>Methods: </strong>Relevant peer-reviewed manuscripts were identified through a comprehensive search of electronic databases, such as PubMed, Embase, and Google Scholar. Studies focusing on the anatomy, biomechanics, and pathology of the FSU, as well as those concerning the application of PRP and MSCs in spinal disorders, were included.</p><p><strong>Results: </strong>The FSU, the smallest structural unit of the spine, consists of 2 vertebrae, an IVD, facet joints, and associated supporting ligaments. The FSU is crucial for absorbing shock, distributing mechanical loads, protecting the spinal cord and nerve roots, and maintaining spinal stability and mobility. Orthobiologic therapies, including PRP and MSCs, have shown promise in modulating disease processes and promoting tissue repair in spinal conditions. Emerging evidence supports the efficacy of these therapies in reducing pain and improving functional outcomes by targeting multiple components of the FSU. A thorough understanding of the biomechanical processes and the dynamic distribution of mechanical load across its various structures is essential to recognizing that chronic LBP often arises from multiple pain generators rather than a single source. Therefore, an integrated treatment approach that addresses these multiple pain generators collectively, considering the FSU and the entire spine, is critical for optimizing patient outcomes.</p><p><strong>Limitations: </strong>Rather than being systematic, this narrative review is focused on providing an overview of the effects of orthobiologics in the treatment of chronic LBP using an FSU approach. The heterogeneity of study designs, variability in treatment protocols, and limited long-term data pose challenges in establishing standardized guidelines for orthobiologic therapies in LBP management.</p><p><strong>Conclusions: </strong>Orthobiologic treatments offer a promising disease-modifying approach by addressing the entire FSU rather than isolated pain generators. Future research should focus on optimi","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 S7","pages":"S145-S156"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893204","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}
<p><strong>Background: </strong>Radiofrequency ablation (RFA) is a minimally invasive technique increasingly utilized in the treatment of musculoskeletal pain, particularly when pharmacological or rehabilitative approaches prove insufficient. However, the thematic evolution and research development of RFA over the past 2 decades have not been explored adequately.</p><p><strong>Objective: </strong>To conduct a comprehensive bibliometric analysis of the global literature on RFA for musculoskeletal pain, identifying publication trends, research focuses, leading contributors, and thematic transitions between 2000 and 2024.</p><p><strong>Study design: </strong>Bibliometric analysis.</p><p><strong>Setting: </strong>Data were retrieved from the Web of Science Core Collection (WoSCC).</p><p><strong>Methods: </strong>A total of 736 English-language articles published between January 1, 2000, and December 31, 2024, were included. Bibliometric tools such as VOSviewer, CiteSpace, and Biblioshiny were used to analyze annual publication trends, co-authorship networks, country/institutional productivity, keyword co-occurrences, co-citation patterns, and citation bursts.</p><p><strong>Results: </strong>A marked increase in publication volume was observed after 2010, with the peak occurring in 2023. The United States led in both publication output and international collaboration. The Johns Hopkins School of Medicine, University of Wisconsin, and University of Utah were among the most productive institutions. Steven P. Cohen and Laxmaiah Manchikanti emerged as the most influential authors, centrally positioned within international co-authorship networks. Meanwhile, Pain Physician, Pain Medicine, and Regional Anesthesia and Pain Medicine were identified as the journals that exerted the greatest impact. Co-citation analysis revealed a thematic shift from early spinal facet interventions and diagnostic blocks toward peripheral applications, especially genicular nerve ablation, and consensus-based clinical practices. Keyword co-occurrence and citation burst analyses identified 3 chronological research themes: firstly, early spinal interventions (2000-2010), secondly, the diagnostic standardization era (2010-2017), and thirdly, expansion into peripheral, imaging-guided, and multidisciplinary applications (2017-2024).</p><p><strong>Limitations: </strong>The analysis was limited to English-language articles indexed in the WoSCC. Conference proceedings, book chapters, and articles from other databases were excluded. Therefore, some relevant studies might not have been captured.</p><p><strong>Conclusion: </strong>This bibliometric analysis demonstrates a steady growth in RFA-related publications globally. While spinal interventions remain the primary focus, an interest in peripheral applications has seen a notable increase. The expansion of RFA reflects both technological advancements and evolving clinical demands. Future studies should focus on long-term outcomes, clinica
背景：射频消融（RFA）是一种微创技术，越来越多地用于治疗肌肉骨骼疼痛，特别是当药物或康复方法证明不足时。然而，近20年来RFA的主题演变和研究进展并没有得到充分的探讨。目的：对全球关于肌肉骨骼疼痛的RFA文献进行全面的文献计量分析，确定2000年至2024年间的出版趋势、研究重点、主要贡献者和主题转换。研究设计：文献计量学分析。设置：数据从Web of Science Core Collection （WoSCC）中检索。方法：纳入2000年1月1日至2024年12月31日发表的736篇英文文章。文献计量工具如VOSviewer、CiteSpace和Biblioshiny用于分析年度出版趋势、合著网络、国家/机构生产力、关键词共现率、共被引模式和引文爆发。结果：2010年以后论文发表量明显增加，2023年达到高峰。美国在出版物产量和国际合作方面都处于领先地位。约翰霍普金斯医学院、威斯康辛大学和犹他大学是最具生产力的机构。Steven P. Cohen和Laxmaiah Manchikanti成为最有影响力的作者，在国际合作网络中处于中心位置。同时，《疼痛医师》、《疼痛医学》和《区域麻醉与疼痛医学》被确定为影响最大的期刊。共引分析揭示了从早期脊柱小关节干预和诊断阻滞到外周应用的主题转变，特别是膝神经消融和基于共识的临床实践。关键词共现和引文爆发分析确定了3个按时间顺序排列的研究主题：第一，早期脊柱干预（2000-2010），第二，诊断标准化时代（2010-2017），第三，扩展到周边，成像引导和多学科应用（2017-2024）。局限性：该分析仅限于在wscc中索引的英文文章。会议记录、书籍章节和其他数据库中的文章被排除在外。因此，一些相关的研究可能没有被捕获。结论：文献计量学分析表明全球rfa相关出版物稳步增长。虽然脊柱干预仍然是主要焦点，但对周边应用的兴趣已经显著增加。射频消融的扩大反映了技术的进步和不断变化的临床需求。未来的研究应侧重于长期结果、临床应用以及基于证据的脊柱和周围适应症治疗算法优化。
{"title":"Radiofrequency Ablation for Musculoskeletal Pain: A Bibliometric Analysis of Global Research Trends (2000-2024).","authors":"Sahide Eda Artuc, Gizem Kilinc Kamaci","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Radiofrequency ablation (RFA) is a minimally invasive technique increasingly utilized in the treatment of musculoskeletal pain, particularly when pharmacological or rehabilitative approaches prove insufficient. However, the thematic evolution and research development of RFA over the past 2 decades have not been explored adequately.</p><p><strong>Objective: </strong>To conduct a comprehensive bibliometric analysis of the global literature on RFA for musculoskeletal pain, identifying publication trends, research focuses, leading contributors, and thematic transitions between 2000 and 2024.</p><p><strong>Study design: </strong>Bibliometric analysis.</p><p><strong>Setting: </strong>Data were retrieved from the Web of Science Core Collection (WoSCC).</p><p><strong>Methods: </strong>A total of 736 English-language articles published between January 1, 2000, and December 31, 2024, were included. Bibliometric tools such as VOSviewer, CiteSpace, and Biblioshiny were used to analyze annual publication trends, co-authorship networks, country/institutional productivity, keyword co-occurrences, co-citation patterns, and citation bursts.</p><p><strong>Results: </strong>A marked increase in publication volume was observed after 2010, with the peak occurring in 2023. The United States led in both publication output and international collaboration. The Johns Hopkins School of Medicine, University of Wisconsin, and University of Utah were among the most productive institutions. Steven P. Cohen and Laxmaiah Manchikanti emerged as the most influential authors, centrally positioned within international co-authorship networks. Meanwhile, Pain Physician, Pain Medicine, and Regional Anesthesia and Pain Medicine were identified as the journals that exerted the greatest impact. Co-citation analysis revealed a thematic shift from early spinal facet interventions and diagnostic blocks toward peripheral applications, especially genicular nerve ablation, and consensus-based clinical practices. Keyword co-occurrence and citation burst analyses identified 3 chronological research themes: firstly, early spinal interventions (2000-2010), secondly, the diagnostic standardization era (2010-2017), and thirdly, expansion into peripheral, imaging-guided, and multidisciplinary applications (2017-2024).</p><p><strong>Limitations: </strong>The analysis was limited to English-language articles indexed in the WoSCC. Conference proceedings, book chapters, and articles from other databases were excluded. Therefore, some relevant studies might not have been captured.</p><p><strong>Conclusion: </strong>This bibliometric analysis demonstrates a steady growth in RFA-related publications globally. While spinal interventions remain the primary focus, an interest in peripheral applications has seen a notable increase. The expansion of RFA reflects both technological advancements and evolving clinical demands. Future studies should focus on long-term outcomes, clinica","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 S7","pages":"S157-S168"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145892852","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}
<p><strong>Background: </strong>Information on the use of intraarticular bipolar pulsed radiofrequency (IA-bPRF) for treating knee osteoarthritis (KOA) is currently limited, and the effectiveness of this technique is not well established. The most effective nonsurgical approach for alleviating pain caused by KOA is still not well-defined.</p><p><strong>Objectives: </strong>Our aim was to investigate the effects of genicular radiofrequency (G-RFT) and IA-bPRF on pain relief and functional improvement in patients with advanced KOA.</p><p><strong>Study design: </strong>Records of 86 patients with KOA who received either G-RFT or IA-bPRF were evaluated retrospectively.</p><p><strong>Setting: </strong>The pain clinic of a state hospital.</p><p><strong>Methods: </strong>KOA patients who received either G-RFT or IA-bPRF were included in the study. The files of patients who were given such interventions between September 2021 and February 2024 were analyzed. Walking pain was evaluated on the numeric rating scale (NRS). Functional assessments were performed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Lequesne Algofunctional Index for Knee (LAI-knee). These evaluations were carried out before the intervention, as well as 2 weeks and 6 months after it.</p><p><strong>Results: </strong>The IA-bPRF group showed significant improvement in NRS scores when pre-intervention scores were compared to those recorded at the sixth month after the surgery, dropping from 8.62 ± 1.01 to 3.81 ± 1.18, while the scores of the G-RFT group improved from 8.90 ± 1.20 to 5.25 ± 3.40. At the sixth month, WOMAC scores decreased from 75.79 ± 16.00 to 34.21 ± 23.12 in the IA-bPRF group and from 79.02 ± 14.73 to 48.43 ± 30.87 in the G-RFT group. From the pre-intervention period to the sixth month after the procedure, LAI-knee scores went from 18.64 ± 4.16 to 9.90 ± 5.78 in the IA-bPRF group and from 18.89 ± 3.84 to 12.55 ± 7.33 in the G-RFT group. All decreases were significant (P < 0.05). However, WOMAC physical function scores decreased more in the IA-bPRF group than in the G-RFT group (P < 0.05). No serious adverse events occurred.</p><p><strong>Limitations: </strong>Our study is subject to several limitations. Primarily, there is a paucity of extensive literature regarding the application of IA-bPRF for KOA. Additionally, our study's sample size is relatively small. This study was conducted at a single center and was retrospective in nature, rather than prospective and randomized, making it challenging to fully control for nuisance variables. Finally, there is a scarcity of comparable studies. These factors may constrain the external validity of our findings.</p><p><strong>Conclusions: </strong>Pain incurred while walking on flat surfaces and up and down stairs was further reduced with IA-bPRF. IA-bPRF is as effective as G-RFT and even more effective than the latter in some subheadings. Furthermore, the former is a safe alternative for r
{"title":"The Comparison of Intraarticular Bipolar Pulsed Radiofrequency and Genicular Nerve Thermal Radiofrequency Ablation for Pain Caused by Osteoarthritis of the Knee.","authors":"Cigdem Yalcin, Mehmet Alper Salman","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Information on the use of intraarticular bipolar pulsed radiofrequency (IA-bPRF) for treating knee osteoarthritis (KOA) is currently limited, and the effectiveness of this technique is not well established. The most effective nonsurgical approach for alleviating pain caused by KOA is still not well-defined.</p><p><strong>Objectives: </strong>Our aim was to investigate the effects of genicular radiofrequency (G-RFT) and IA-bPRF on pain relief and functional improvement in patients with advanced KOA.</p><p><strong>Study design: </strong>Records of 86 patients with KOA who received either G-RFT or IA-bPRF were evaluated retrospectively.</p><p><strong>Setting: </strong>The pain clinic of a state hospital.</p><p><strong>Methods: </strong>KOA patients who received either G-RFT or IA-bPRF were included in the study. The files of patients who were given such interventions between September 2021 and February 2024 were analyzed. Walking pain was evaluated on the numeric rating scale (NRS). Functional assessments were performed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Lequesne Algofunctional Index for Knee (LAI-knee). These evaluations were carried out before the intervention, as well as 2 weeks and 6 months after it.</p><p><strong>Results: </strong>The IA-bPRF group showed significant improvement in NRS scores when pre-intervention scores were compared to those recorded at the sixth month after the surgery, dropping from 8.62 ± 1.01 to 3.81 ± 1.18, while the scores of the G-RFT group improved from 8.90 ± 1.20 to 5.25 ± 3.40. At the sixth month, WOMAC scores decreased from 75.79 ± 16.00 to 34.21 ± 23.12 in the IA-bPRF group and from 79.02 ± 14.73 to 48.43 ± 30.87 in the G-RFT group. From the pre-intervention period to the sixth month after the procedure, LAI-knee scores went from 18.64 ± 4.16 to 9.90 ± 5.78 in the IA-bPRF group and from 18.89 ± 3.84 to 12.55 ± 7.33 in the G-RFT group. All decreases were significant (P < 0.05). However, WOMAC physical function scores decreased more in the IA-bPRF group than in the G-RFT group (P < 0.05). No serious adverse events occurred.</p><p><strong>Limitations: </strong>Our study is subject to several limitations. Primarily, there is a paucity of extensive literature regarding the application of IA-bPRF for KOA. Additionally, our study's sample size is relatively small. This study was conducted at a single center and was retrospective in nature, rather than prospective and randomized, making it challenging to fully control for nuisance variables. Finally, there is a scarcity of comparable studies. These factors may constrain the external validity of our findings.</p><p><strong>Conclusions: </strong>Pain incurred while walking on flat surfaces and up and down stairs was further reduced with IA-bPRF. IA-bPRF is as effective as G-RFT and even more effective than the latter in some subheadings. Furthermore, the former is a safe alternative for r","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 S7","pages":"S179-S189"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145892861","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":"2025 Index by Content.","authors":"Asipp","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 S7","pages":"S251-S268"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893070","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":"2025 Index by Key Words.","authors":"Asipp","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 S7","pages":"S275-S279"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893139","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":"2025 Index by Author.","authors":"Asipp","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"28 S7","pages":"S269-S274"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893161","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}
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