Details

Autor(en) / Beteiligte

• Becker, Stephan, M.D
• Hadjipavlou, Alexander, M.D
• Heggeness, Michael H., M.D

Titel

Ablation of the basivertebral nerve for treatment of back pain: a clinical study

Ist Teil von

• The spine journal, 2017-02, Vol.17 (2), p.218-223

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2017

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Background Content Lumbar axial back pain arising from degenerative disc disease continues to be a challenging clinical problem whether treated with non-surgical management, local injection, or motion segment stabilization and fusion. Purpose To determine the efficacy of intraosseous basivertebral nerve ablation for the treatment of chronic lumbar back pain in a clinical setting. Study Design Patients meeting predefined inclusion/exclusion criteria were enrolled in a study using RF energy to ablate the basivertebral nerve within the vertebral bodies adjacent to the diagnosed level. Patients were evaluated at 6 weeks, and 3, 6, and 12 months post-operatively. Patient Sample Seventeen patients with chronic, greater than 6 months, low back pain unresponsive to at least 3 months of conservative care were enrolled. Sixteen patients were treated successfully following screening using MRI finding of Modic Type I or II changes and/or positive confirmatory discography to determine the affected levels. The treated population consisted of eight male and eight female patients; the mean age was 48 years (34-66 years). Outcome Measures Self-reported outcome measures were collected prospectively at each follow-up interval. Measures included the Oswestry Disability Index (ODI), Visual Analogue Score (VAS), and Medical Outcomes Trust 36-Item Short Form Health Survey (SF-36). Methods This is an industry sponsored study to evaluate the effectiveness of intraosseous nerves in the treatment of chronic Back pain. Consented and enrolled patients underwent ablation of the basivertebral nerve using RF energy (INTRACEPTTM system, Relievant Medsystems, Redwood City, CA) guided in a transpedicular or extrapedicular approach. Preoperative planning determined targeted ablation zone and safety zones. Results Mean baseline ODI of the treated cohort was 52 ± 13, decreasing to a mean of 23 ± 21 at three months follow-up (p < 0.001). The statistically significant improvement in ODI observed at 3 months was maintained through the 12 month follow-up. The mean baseline VAS decreased from 61 ± 22 to 45 ± 35 at three months follow-up (p < 0.05) and the mean baseline Physical Component Summary (PCS SF-36) increased from 34.5 ± 6.5 to 41.7 ± 12.4 at three months follow-up (p = 0.03). Conclusion Ablation of the basivertebral nerve for the treatment of chronic lumbar back pain significantly improves patients' self-reported outcome early in the follow-up period; the improvement persisted throughout the one year study period.