Background:Trigeminal postherpetic neuralgia (TPHN) is a severe chronic pain that can lead to various socioeconomic consequences. Therefore, it is necessary to explore optimal treatment options for acute/subacute herpes zoster (HZ)–related trigeminal neuralgia and prevent the further development of TPHN. High‐voltage, long‐duration pulsed radiofrequency (HL‐PRF) of the Gasserian ganglion is a new surgical intervention used to treat PHN. A ganglion block has been reported to possess anti‐inflammatory effects and potential analgesic benefits.Methods:We included 83 patients with HZ‐related acute/subacute trigeminal neuralgia admitted from January 1, 2021, to June 1, 2023, and received Gasserian ganglion HL‐PRF combined with block. A 6‐month follow‐up was conducted, including Numerical Rating Scale (NRS) scores, Pittsburgh Sleep Quality Index (PSQI), the incidence of TPHN, the dosage of anticonvulsants and analgesics, efficacy, and adverse events.Results:All patients showed a significant decrease in postoperative NRS scores (p< 0.05). The NRS scores of the acute HZ group were consistently lower than those of the subacute HZ group at different time points (p< 0.01). The overall incidence of TPHN from the onset of HZ to 12 weeks is 21.68%. The incidence of TPHN in the acute phase group was 12.77%, significantly lower than the 33.33% in the subacute phase group (p= 0.024). The effective rate was 74.7% in all patients, at 3 months after the treatment. The effective rate was 82.98% in the acute phase group and 63.89% in the subacute phase group, showing a statistically significant difference (p= 0.047). The PSQI score of the acute group was consistently lower than that of the subacute group (p< 0.01). The dosage of analgesics and anticonvulsants used in the acute HZ group was lower than that in the subacute group (p< 0.01). All patients did not experience serious adverse reactions.Conclusions:Gasserian ganglion HL‐PRF combined with block can be an effective and safe technique to relieve the pain of acute/subacute zoster‐related trigeminal neuralgia and prevent the incidence of TPHN.

Transforaminal epidural steroid injection (TFESI) is widely used to manage lumbar radiculopathy. In clinical settings, patients often undergo repeated transforaminal epidural injections with or without steroid administration. To examine whether a positive response to TFESI at the first month, can in clinical settings, identify patients with radiculopathy who can avoid surgery for two years. Study Design/Setting. This prospective observational study was conducted at an academic medical center. Individuals aged ≥20 years who had been referred to our pain center by spine surgeons were enrolled. All patients were assessed using the Numerical Rating Scale (NRS) at baseline and 1 month after the first TFESI. Patients were divided into two groups according to the NRS decrement: the positive response (PR) group achieved a ≥2.0 decrease on the NRS 1 month after the first TFESI compared to baseline and the no response (NR) group achieved a <2.0 decrease on the NRS. The incidence rates of surgery over two years were compared between the two groups. In addition, we calculated the hazard ratio of the PR group to the NR group regarding the incidence of surgery over two years using the Cox proportional hazard model, adjusting for baseline NRS. Seventy-six patients completed the two-year follow-up. In total, 8 and 68 patients had bilateral and unilateral radiculopathy, respectively. The PR and NR groups included 35 and 41 patients, respectively. The rate of surgery avoidance was 85.7% and 73.2% in the PR and NR groups, respectively. This difference was not statistically significant (p=0.26). After adjusting for baseline NRS, the hazard ratio of the PR group to the NR group regarding the incidence of surgery within two years was 0.35 (95% confidence interval: 0.11-1.11, p=0.08). A positive response to TFESI may not identify patients who can avoid surgery for two years.

To examine the efficacy and safety of ozonated autohemotherapy (O3-AHT) combined with pharmacological therapy for comorbid insomnia and myofascial pain syndrome (MPS). One hundred and eighteen patients were randomly divided into two groups: the control group (N = 50) and the O3-AHT group (N = 53). Patients in both groups were given the same pharmacological management for three weeks. Patients in the O3-AHT group were treated with ozonated autohemotherapy (the concentration of ozone was 20 µg/ml in the first week, 30 µg/ml in the second week, and 40 µg/ml in the third week) combined with pharmacological therapy. Primary (the insomnia severity index (ISI) and visual analogue scale (VAS)) and secondary outcomes (the Epworth sleepiness scale (ESS), polysomnography data, the anxiety and preoccupation about sleep questionnaire (APSQ), the beck depression index (BDI), and the multidimensional fatigue inventory (MFI)) were examined at pretreatment, posttreatment, 1 month, and 6 months. Fifty patients in the control group and fifty-three patients in the O3-AHT group completed the study. In both groups, insomnia and pain symptoms were relieved significantly compared with pretreatment. Compared with the control group, the O3-AHT group had significantly improved sleep quality, pain, and negative mood at different time points. No adverse complications were observed in either group. Compared with pharmacological therapy alone, ozonated autohemotherapy combined with pharmacological therapy can ameliorate insomnia, reduce pain intensity, improve negative mood, and alleviate fatigue more effectively without serious adverse complications.

Objective The aim of the study is to explore the characteristics of systolic blood pressure (SBP) and heart rate (HR) changes in patients undergoing percutaneous balloon compression (PBC) for trigeminal neuralgia and analyze the factors that influence the formation of the symbolic pear shape of the balloon, which signifies successful compression. Methods We retrospectively analyzed the changes in systolic blood pressure (SBP) and heart rate (HR) in 103 consecutive patients with trigeminal neuralgia (TN). Fifty-five patients who underwent operations with intermittent inflating cuff blood pressure (IICBP) monitoring were classified into the IICBP group. The other 48 patients who underwent continuous intra-arterial blood pressure (CIABP) monitoring were classified into the CIABP group. Results Among all the patients, there were more women than men and the patients in both the groups more commonly had TN on the right side and involving branch III. First, the balloon appeared as “pear-shaped” when the compression was effective, and the SBP increased an average of 59.04% in the CIABP group. CIABP provided us the precise range of the increase. Older patients had higher SBPs, especially patients with hypertension. Second, SBP was more sensitive and lasted much longer than HR in the process of puncturing the foramen ovale and compressing the ganglion. SBP fluctuated much more in the CIABP group than in the IICBP group. Third, the median time taken in the CIABP group was less than the IICBP group, and the prognosis of the CIABP group was better than the IICBP group. Conclusion Effective ganglion compression significantly increased SBP. CIABP can monitor SBP in real time and can also safeguard the compression process. CIABP is a safe and effective method in the PBC process that is worthy of promotion and application.

Objectives This study aims at investigating the internal heat acupuncture (IHA) combined with the high-voltage long-duration pulsed radiofrequency (PRF) therapeutic effect on subacute postherpetic neuralgia (PHN). Methods This retrospective study comprised 81 cases with PHN. They were divided into three groups: IHA combined with the high-voltage long-duration PRF group (IHA-PRF), intradermal injection combined with the high-voltage long-duration PRF group (II-PRF), and the high-voltage long-duration PRF group. The pain numerical rating score (NRS), IL-6, Gal-3, and blood glucose levels were recorded before and after treatment. Results Compared with before treatment, NRS scores of the three groups were all decreased at each time point. NRS scores of the IHA-PRF group patients decreased significantly in comparison to the PRF group at 1, 4, 8, and 12 weeks following treatment, while group II-PRF only decreased significantly at one week following treatment. Compared with groups II-PRF and PRF, respectively, IL-6 and Gal-3 levels in plasma of patients in group IHA-PRF were significantly decreased at 4 and 12 weeks after treatment. The effective rate of group IHA-PRF was 88.9%, which was considerably more than the other groups, II-PRF (63.0%) and PRF (63.0%). Compared with group II-PRF, patients' blood glucose levels in IHA-PRF and PRF groups significantly decreased three days and one week after treatment. Conclusion Internal heat acupuncture combined with high-voltage long-duration pulsed radiofrequency has a satisfactory therapeutic effect on subacute PHN and has no obvious adverse reactions, which is especially suitable for patients with poor blood glucose control.

Objective Posterior instrumented fusion is the most widely accepted surgical treatment for spinal stenosis with degenerative lumbar scoliosis (DLS). However, long fusion can affect daily activities due to lumbar stiffness. Dynamic stabilization has been introduced to overcome the drawbacks of fusion in recent years. This study aimed to compare the outcomes of dynamic stabilization (Dynesys system) with posterior instrumented fusion for the management of spinal stenosis with DLS. Methods This study retrospectively reviewed 65 consecutive patients with spinal stenosis and DLS who were undergoing surgical treatment between January 2013 and December 2017. Among them, 34 patients (Dynesys group) had fenestration decompression and Dynesys stabilization, whereas 31 patients (fusion group) underwent posterior instrumented fusion. Clinical outcomes, radiographic data, and postoperative complications were compared between the two groups. Results The mean number of fixed segments was 3.6 ± 0.9 in the Dynesys group and 4.2 ± 1.0 in the fusion group. Lower average values of operating time and blood loss were observed in the Dynesys group (P < 0.05). At an average follow-up of 42 months, there were no significant differences in the visual analog scale for the leg pain (VASleg), the scoliosis Cobb's angle, and the lumbar lordosis between the two groups (P > 0.05). The visual analog scale for back pain (VASback), oswestry disability index (ODI), and lumbar stiffness disability index (LSDI) scores of the Dynesys group were lower compared with the fusion group (P < 0.05). The range of motion (ROM) of implanted segments was significantly higher in the Dynesys group as compared to the fusion group (P < 0.05). The overall complications were less in the Dynesys group, but the difference was not statistically significant (P > 0.05). Conclusion Both dynamic stabilization and instrumented fusion can improve the clinical outcomes of patients with spinal stenosis and mild DLS. Compared to instrumented fusion, dynamic stabilization has the advantages of less invasion and motion preservation.

Objectives As a urinary dysfunction disorder, stress urinary incontinence (SUI) is more common in women than in men. Acupuncture, a traditional minimally invasive technique, has potential efficacy in the treatment of SUI. The purpose of this overview is to critically assess the available evidence on acupuncture for the treatment of SUI in women. Methods Two researchers searched seven databases for systematic reviews (SRs)/meta-analyses (MAs) of randomized controlled trials (RCTs) on acupuncture for SUI. Two researchers assessed the included SRs/MAs using the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2), the Risk of Bias in Systematic (ROBIS) scale, the list of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Results Eight published SRs/MAs were included in our overview. According to the results of the AMSTAR-2 assessment, all SRs/MAs were of very low quality. According to the ROBIS evaluation results, no SR/MA was assessed as low risk of bias. According to the results of the PRISMA checklist assessment, no SR/MA was fully reported on the checklist. According to GRADE, a total of 27 outcomes extracted from the included SRs/MAs were evaluated, and only 1 was rated as high quality. Conclusions Acupuncture may be an effective and safe complementary treatment for SUI in women. However, further standard and comprehensive SRs/MAs and RCTs are needed to provide an evidence-based medical rationale for this.

Evidence shows that chronic prostatitis/chronic pelvic pain syndrome hugely impacts the body and mind. The central mechanisms in patients with CP/CPPS resulted in increased attention as neuroimaging techniques developed. This review investigated the study design and major neuroimaging findings in CP/CPPS patients to provide comprehensive evidence. Seven databases were searched and screened: PubMed, EMBASE/SCOPUS, Cochrane Library Database, China National Knowledge Infrastructure, VIP, Wanfang, and China Biology Medicine disc. Nine studies were eventually included in the analysis. The results demonstrate that the insula, anterior cingulate gyrus, postcentral gyrus, and precuneus are significantly associated with CP/CPPS patients' pain feelings and cause dysregulation of painful emotions, lowering patients' tolerance to stimulus.

Background Cognitive-behavioral therapy (CBT) is commonly adopted in pain management programs for patients with chronic low back pain (CLBP). However, the benefits of CBT are still unclear. Objectives This review investigated the effectiveness of CBT on pain, disability, fear avoidance, and self-efficacy in patients with CLBP. Methods Databases including PubMed, EMBASE, Web of Science, Cochrane Library, and PsycINFO were searched. RCTs examining the effects of CBT in adults with CLBP were included. The data about the outcome of pain, disability, fear avoidance, and self-efficacy were retained. Subgroup analysis about the effects of CBT on posttreatment was conducted according to CBT versus control groups (waiting list/usual care, active therapy) and concurrent CBT versus CBT alone. A random-effects model was used, and statistical heterogeneity was explored. Results 22 articles were included. The results indicated that CBT was superior to other therapies in improving disability (SMD −0.44, 95% CI −0.71 to −0.17, P < 0.05), pain (SMD −0.32, 95% CI −0.57 to −0.06, P < 0.05), fear avoidance (SMD −1.24, 95% CI −2.25 to −0.23, P < 0.05), and self-efficacy (SMD 0.27, 95% CI 0.15 to 0.40, P < 0.05) after intervention. No different effect was observed between CBT and other therapies in all the follow-up terms. Subgroup analysis suggested that CBT in conjunction with other interventions was in favor of other interventions alone to reduce pain and disability (P < 0.05). Conclusion CBT is beneficial in patients with CLBP for improving pain, disability, fear avoidance, and self-efficacy in CLBP patients. Further study is recommended to investigate the long-term benefits of CBT. This meta-analysis is registered with Prospero (registration number CRD42021224837).