{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T14:06:46Z","timestamp":1780582006174,"version":"3.54.1"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pain Res."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At 1 month, the US cohort reported a mean VAS score of 33.52\u2009\u00b1\u200914.30\u2005mm with a mean difference of 1.04\u2005mm compared to the FL cohort, indicating non-inferiority as the upper limit of the 95% confidence interval of 4.36\u2005mm fell within the non-inferior margin of 10\u2005mm. PHN occurred in 16.7% and 13.9% of cases in the US and FL cohorts at 3 months after rash onset (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.796), respectively. Both cohorts showed similar improvements in 3-month VAS scores (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.310), rescue analgesics (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;gt;\u20090.05), and EQ-5D scores (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;gt;\u20090.05). Compared to the FL cohort, the US approach was associated with a wider anesthetic dermatome [3.25 (IQR: 2.75, 3.75) vs. 3 (IQR: 2.5, 3.5) levels for 3\u2005mL of therapeutic injectate,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.031], fewer needle insertions [1 (IQR: 0, 2) vs. 2.5 (IQR: 1.5, 3.5),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005], shorter procedure duration (14.09\u2009\u00b1\u20093.58 vs. 19.70\u2009\u00b1\u20094.84\u2005min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), and less radiation exposure (1,226.89\u2009\u00b1\u2009377.28 vs. 5,607.50\u2009\u00b1\u20091,391.38 \u00b5Gy\u00b7m\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). No serious adverse events were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpain.2026.1768584","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T05:46:07Z","timestamp":1779255967000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Ultrasound-guided retro-neural transforaminal injection with fluoroscopic confirmation for zoster-associated pain: a retrospective propensity score-matched analysis"],"prefix":"10.3389","volume":"7","author":[{"given":"Xiuhua","family":"Li","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Beijing Tongren Hospital, Capital Medical University","place":["Beijing, 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