ArticleFrontiers in pain research (Lausanne, Switzerland)2026
Ultrasound-guided retro-neural transforaminal injection with fluoroscopic confirmation for zoster-associated pain: a retrospective propensity score-matched analysis.
Article in Frontiers in pain research (Lausanne, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: This study aimed to evaluate the efficacy and safety of an ultrasound (US)-guided lumbar transforaminal steroid injection (TFI) using the retro-neural approach for relieving acute zoster-associated pain (ZAP) in the lower extremities. Methods: A total of 72 patients who underwent US-guided retro-neural TFI were retrospectively stratified as the US cohort. Furthermore, 1:1 propensity score matching was performed to select controls who underwent fluoroscopy (FL)-guided procedures. The primary endpoint was visual analog scale (VAS) pain scores at 1 month after the procedure. Secondary outcomes included sensory blockade, procedure duration, radiation exposure, adverse events, rescue analgesic use, post-herpetic neuralgia (PHN) incidence, and European Quality of Life Five-Dimension questionnaire (EQ-5D) score. Results: At 1 month, the US cohort reported a mean VAS score of 33.52 ± 14.30 mm with a mean difference of 1.04 mm compared to the FL cohort, indicating non-inferiority as the upper limit of the 95% confidence interval of 4.36 mm fell within the non-inferior margin of 10 mm. PHN occurred in 16.7% and 13.9% of cases in the US and FL cohorts at 3 months after rash onset ( Conclusions: US-assisted lumbar retro-neural RFI was statistically non-inferior to conventional procedures under FL guidance for treating ZAP in the lower extremities. It provided the benefits of fewer needle attempts, a shorter procedure duration, and decreased radiation exposure, supporting its use in clinical routine practice.
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