Alonso Guardo L, et al. Korean J Pain. 2016 Jan;29(1):23-28. https://doi.org/10.3344/kjp.2016.29.1.23

Background and Objectives: The International Society for Modulation defines persistent spinal pain syndrome type 2 (PSPS-type 2), formerly known as failed back surgery syndrome, as a condition where patients continue to experience pain or develop new pain following spinal surgery intended to alleviate back or lower-limb discomfort. PSPS-type 2 is characterized by pain and significant disability, affecting quality of life. Spinal cord stimulation has proven effective in treating this syndrome, although the role of psychological factors, such as pain catastrophizing and central sensitization, remain unclear. This study seeks to examine the potential connection between psychosocial responses and both functionality and pain perception in patients with persistent spinal pain syndrome type 2 who have undergone spinal cord stimulation treatment. Materials and Methods: A single-site, cross-sectional study was conducted on individuals diagnosed with persistent spinal pain syndrome type 2 who were receiving spinal cord stimulation. Study participants were required to meet specific eligibility criteria and were assessed for disability, pain perception, fear of movement, pain catastrophizing, and central sensitization. The spinal cord stimulation procedure involved the placement of electrodes at vertebral levels T8–T11 for precise pain control, with a particular focus on targeting the dorsal root ganglion to alleviate chronic pain. Results: Thirty-seven patients with persistent spinal pain syndrome type 2 have undergone spinal cord stimulation treatment for 4.68 ± 5.25 years. Clinical assessments indicated a pain perception score of 5.6 ± 1.96, Central Sensitization Inventory score of 42.08 ± 18.39, disability score of 37.62 ± 16.13, fear of movement score of 33.11 ± 8.76, and pain catastrophizing score of 28.43 ± 13.14. Finally, pain catastrophizing was significantly associated with pain perception (β = 0.075 and p = 0.008) and disability (β = 0.90 and p < 0.01). Conclusions: Catastrophizing plays a crucial role in pain perception and disability among patients with persistent spinal pain syndrome type 2 receiving spinal cord stimulation. Integrating psychological interventions may improve clinical outcomes for these patients.

Background: Ultrasound is very important in medicine and teaching, but there are not many formal training programs. We also do not know much about what students think. To be good at using ultrasound, one needs to learn technical, thinking, and seeing skills. This is especially true in regional anesthesia (RA), where mistakes in reading images can cause problems. Training with simulations is a safe and good way to learn these skills. Some models are helpful for teaching how to perform procedures using ultrasound. Objective: This study aimed to evaluate the effectiveness, localization time, and success rate of traditional teaching versus a new simulation-based teaching method for RA designed by the investigators among undergraduate medical students. Methods: A prospective, randomized controlled trial was conducted at the University of Salamanca from April 2022 to January 2023. A total of 34 medical students in their fourth to sixth academic years were randomly allocated to either a simulation-based training group using the Haptic Ultrasound Probe or a traditional teaching group. The simulation approach used a realistic probe replica and a software-based ultrasound environment, whereas the traditional method comprised a theoretical lecture and curated audiovisual materials. Two days after training, participants underwent a blinded assessment requiring the identification of peripheral nerve plexuses using an ultrasound device. The primary outcome measured was the successful identification of nerves, and the secondary outcome was the time taken to complete each procedure. Data were analyzed using an intention-to-treat approach. Results: A total of 34 medical students (fourth to sixth years) were recruited to compare traditional teaching with simulation-based training in ultrasound-guided nerve localization. No statistically significant differences were found in the success rates between the groups. For the interscalene approach, the traditional teaching group achieved a 100% (17/17) success rate compared to 82% (14/17) in the simulation group (P=.07). The time to task completion was similar across most procedures. In the sciatic nerve division, the traditional teaching group was significantly faster, with a mean time of 42.4 (SD 39.5) seconds (P=.02). The regression models showed no significant interaction between the intervention type and academic year. Both teaching methods had positive educational impacts. Conclusions: Simulation-based learning effectively supports competency acquisition in RA and offers a safe, scalable alternative to traditional methods. Its integration into medical curricula may standardize training, improve skill consistency, and enhance patient safety. Further multicenter studies with larger, diverse cohorts are needed to validate these benefits and guide implementation in medical education.