Guidelines From the American Society of Pain and Neuroscience for Using Artificial Intelligence in Interventional Spine and Nerve Treatment.

Introduction: Artificial intelligence (AI) is rapidly evolving and becoming more ubiquitous. Significant advancements have been made in the last few years, driving rapidly increasing adoption. The scale of publications on AI makes it difficult to keep abreast of relevant findings.

Diagnostic Guidance for Chronic Complex Regional Pain Syndrome Type I and Type II from The American Society of Interventional Physicians (ASIPP).

Background: Complex Regional Pain Syndrome (CRPS) is a challenging and often disabling condition marked by persistent pain, most commonly in a limb following injury or surgery. It presents with a wide array of symptoms, including intense pain, swelling, alterations in skin color and temperature, motor dysfunction, and trophic changes such as skin and tissue atrophy. While the precise cause of CRPS is not fully understood, it is thought to stem from abnormal nervous system activity, leading to heightened pain sensitivity and inflammatory responses.

Chronic Abdominal Discomfort Syndrome (CADS): A Narrative Review of Treatment Strategies.

Chronic Abdominal Discomfort Syndrome (CADS) is a recently proposed term that is a subclassification of Chronic Abdominal Pain, characterized by symptoms affecting clinical, diagnostic, and functional domains. Patients with CADS often have a history of abdominal surgery and experience chronic gastrointestinal symptoms such as nausea, bloating, vomiting, and dyspepsia. This review explores the underlying pathophysiology of CADS, emphasizing the role of the sympathetic and parasympathetic nervous systems in pain transmission.

Long-Term Efficacy of a Novel Extraforaminal Approach for Nerve Root Stimulation in Complex Regional Pain Syndrome: A Case Report.

BACKGROUND: Neuromodulation techniques can be employed as part of the treatment approach for refractory complex regional pain syndrome (CRPS). CASE REPORT: We present a case report of a 62-year-old male patient with CRPS of the lower limb who underwent spinal nerve root stimulation using a novel extraforaminal lead placement as a treatment modality after the failed replacement of a defective dorsal root ganglion lead. This case report highlights the successful long-term application of dorsal nerve root stimulation with an alternative extraforaminal lead placement technique, resulting in significant pain relief and improved functional outcomes in a patient with refractory CRPS.

Safety and Efficacy of Platelet-Rich Plasma versus Genicular Nerve Radiofrequency Ablation in Knee Osteoarthritis: An Open-Label, Prospective, Randomized, Clinical Trial.

Background: Osteoarthritis is the most prevalent joint disorder, marked by significant pain, reduced functionality, and diminished quality of life. The prevalence of chronic knee osteoarthritis is increasing as the population ages. Minimally invasive therapeutic interventions, including platelet-rich plasma and radiofrequency ablation of genicular nerves, have demonstrated substantial efficacy in alleviating pain in these patients.

A Comprehensive Review of Treatment Approaches to Ilioinguinal Neuralgia.

Background: Ilioinguinal neuralgia is a frequent cause of pain in the lower abdomen, genitals, and upper thighs and is commonly caused iatrogenically. Patients with ilioinguinal neuralgia often have a history of surgical interventions such as hernia repairs, appendectomies, or hysterectomies.

Objectives: The objective of this narrative literary review is to catalog and provide an organized level of evidence for the available interventions for treating ilioinguinal neuralgia.

A Review of Nonsurgical Neurolytic Procedures for Neuropathic Pain.

Introduction: Ideally, a physical or chemical nonsurgical neurolytic procedure provides targeted neurolysis to relieve pain for a suitable length of time without causing complications. This narrative review focuses on five nonsurgical neurolytic procedures that are well-established and well-documented in the literature for the treatment of refractory neuropathic pain and peripheral neuropathies, in particular: two physical nonsurgical neurolytic techniques (cryoablation and radiofrequency ablation) and three chemoneurolytic agents (alcohol injection, phenol injection, and a high-concentration capsaicin 8% topical system).

Methods: Using the definition of nonsurgical physical and chemical neurolytic procedures for neuropathic pain, a focused literature search of the PubMed database for English-language, human studies published through July 2024 included, but was not limited to, the following search terms: "neuropathic pain" AND "cryoablation", "cryoneurolysis", "radiofrequency ablation", "alcohol neurolysis", "alcohol injection", "phenol neurolysis", "phenol injection", "chemoneurolysis", "topical capsaicin", and "TRPV1.

Scoping Review: The Effects of Interrupted Onabotulinumtoxin A Treatment for Chronic Migraine Prevention During the COVID-19 Pandemic.

Objective: To systematically examine the literature on the clinical consequences of inadvertent delays in scheduled onabotulinumtoxin A (OTA) therapy for chronic migraine during the COVID-19 pandemic and assess recommendations when access to OTA is limited.

Background: The coronavirus (COVID-19) pandemic was unprecedented in its impact on the global medical community. Most healthcare institutions in the United States (US) and the world had begun significantly limiting elective procedures, undermining management of many debilitating chronic conditions.

The Analgesic Effectiveness of Genicular Nerve-targeted Cooled and Pulsed Radiofrequency Ablation for Osteoarthritis Knee Pain: A Systematic Review and Meta-analysis.

Background: Radiofrequency ablation (RFA) is a form of therapy for knee osteoarthritis (OA) pain that has become more popular in recent years. In addition to standard RF approaches, there are cooled and pulsed options. RFA could be used to treat the superolateral, superomedial, and inferomedial branches of the genicular nerves.

Evidence-Based Clinical Practice Guidelines on Regenerative Medicine Treatment for Chronic Pain: A Consensus Report from a Multispecialty Working Group.

Purpose: Injectable biologics have not only been described and developed to treat dermal wounds, cardiovascular disease, and cancer, but have also been reported to treat chronic pain conditions. Despite emerging evidence supporting regenerative medicine therapy for pain, many aspects remain controversial.

Methods: The American Society of Pain and Neuroscience (ASPN) identified the educational need for an evidence-based guideline on regenerative medicine therapy for chronic pain.

Mechanisms of Action of Dorsal Root Ganglion Stimulation.

The dorsal root ganglion (DRG) serves as a pivotal site for managing chronic pain through dorsal root ganglion stimulation (DRG-S). In recent years, the DRG-S has emerged as an attractive modality in the armamentarium of neuromodulation therapy due to its accessibility and efficacy in alleviating chronic pain refractory to conventional treatments. Despite its therapeutic advantages, the precise mechanisms underlying DRG-S-induced analgesia remain elusive, attributed in part to the diverse sensory neuron population within the DRG and its modulation of both peripheral and central sensory processing pathways.

Evaluation and Treatment of Sacroiliac Joint Pain in Patients with History of Vertebral Compression Fractures: A Retrospective Case Series.

Background: Vertebral compression fractures (VCFs) can affect the entire spinopelvic complex and cause unpredictable patterns of back pain due to their effects on spinal tensegrity and biomechanical compensation. They can lead to significant morbidity and mortality in the aging population and are difficult to diagnose. We aimed to establish a relationship between VCFs and sacroiliac (SI) joint pain.

Sacroiliac Joint Denervation-A Novel Approach to Target Sacral Lateral Branches: A Practical Approach.

Introduction: Sacroiliac joint (SIJ) pain is a relatively common cause of low back pain. Percutaneous radiofrequency (RF) techniques for SIJ are limited to ablation of the posterior SIJ innervation. Different techniques have been described for SIJ radiofrequency ablation, including conventional thermal, cooled RF, pulsed RF, bipolar RF, and specialized tip RF needle (i.

Effects of local anesthetics and contrast agents on musculoskeletal regenerative medicine procedures.

In regenerative medicine, cells, tissues and organs are often replaced, engineered or regrown in order to restore their function after they have been damaged or lost. Local anesthetics, corticosteroids and contrast agents are commonly employed for both diagnostic and therapeutic objectives in interventional pain and musculoskeletal treatments for regenerative medicine. There is growing evidence that routine injectables promote catabolism and disease processes.

The Role of Neuromodulation in Chronic Pelvic Pain: A Review Article.

Background: Chronic pelvic pain (CPP) is a complex, heterogeneous condition affecting both female and male patients with significant effects on quality of life. Chronic pelvic pain is a prevalent but often underdiagnosed condition due to the variation in patient presentation, a gap in communication among specialties, under-reporting of the syndrome, and lack of standardized diagnostic criteria with a subsequent delay in diagnosis. The mechanism of CPP is complex due to multifactorial etiologies of pain and its vast anatomy and innervation.

The Neurostimulation Appropriateness Consensus Committee (NACC): Recommendations on Best Practices for Cervical Neurostimulation.

Introduction: The International Neuromodulation Society convened a multispecialty group of physicians based on expertise with international representation to establish evidence-based guidance on the use of neurostimulation in the cervical region to improve outcomes. This Neurostimulation Appropriateness Consensus Committee (NACC) project intends to provide evidence-based guidance for an often-overlooked area of neurostimulation practice.

Materials And Methods: Authors were chosen based upon their clinical expertise, familiarity with the peer-reviewed literature, research productivity, and contributions to the neuromodulation literature.