Division of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, Utah, USA.
Division of Physical Medicine & Rehabilitation, Department of Orthopaedic Surgery, Stanford University, Redwood City, California, USA.
Pain Med. 2021 Jul 25;22(Suppl 1):S24-S30. doi: 10.1093/pm/pnab117.
Recently, basivertebral nerve (BVN) radiofrequency ablation has been developed for the treatment of chronic low back pain (CLBP) thought to arise from the vertebral body endplates (VEPs). This review describes the relevant neuroanatomy and pathobiology of VEP degeneration and injury, imaging correlates of presumed VEP pain, randomized controlled trials performed, appropriate patient selection, and safety. Anatomic, histological, and clinical evidence supports the concept of the VEP as a source of CLBP and the nociceptive role of the BVN. BVN radiofrequency ablation appears to be an effective treatment for a subset of patients with CLBP and evidence of Modic change types 1 and 2 in the L3 to S1 VEPs who have failed to respond to conservative treatment. However, all studies performed to date have been industry sponsored, and future non-industry-funded trials will be needed to confirm these results.
最近，为治疗源自椎体终板（VEPs）的慢性下腰痛（CLBP），开发了经椎旁脊神经射频消融术。本文综述了 VEPs 退变和损伤的相关神经解剖学和病理生理学、推测的 VEPs 疼痛的影像学相关性、已开展的随机对照试验、合适的患者选择和安全性。解剖学、组织学和临床证据支持 VEPs 是 CLBP 的一个来源以及 BVN 具有痛觉作用的概念。BVN 射频消融术似乎是治疗一组保守治疗无效的 CLBP 患者和 L3 至 S1 VEPs 存在 Modic 改变 1 型和 2 型证据患者的有效治疗方法。然而，迄今为止开展的所有研究均由行业赞助，未来需要开展非行业资助的试验来证实这些结果。
