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美国疼痛与神经科学学会关于经椎基底部神经消融术治疗脊椎源性疼痛的最佳实践指南

Best Practice Guidelines on the Diagnosis and Treatment of Vertebrogenic Pain with Basivertebral Nerve Ablation from the American Society of Pain and Neuroscience.

作者信息

Sayed Dawood, Naidu Ramana K, Patel Kiran V, Strand Natalie H, Mehta Pankaj, Lam Christopher M, Tieppo Francio Vinicius, Sheth Samir, Giuffrida Anthony, Durkin Brian, Khatri Nasir, Vodapally Shashank, James Christopher O, Westerhaus Benjamin D, Rupp Adam, Abdullah Newaj M, Amirdelfan Kasra, Petersen Erika A, Beall Douglas P, Deer Timothy R

机构信息

Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, KS, USA.

Anesthesiology, California Orthopedics & Spine, Marin, CA, USA.

出版信息

J Pain Res. 2022 Sep 14;15:2801-2819. doi: 10.2147/JPR.S378544. eCollection 2022.


DOI:10.2147/JPR.S378544
PMID:36128549
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9482788/
Abstract

Chronic low back pain is a worldwide leading cause of pain and disability. Degenerative disc disease has been the presumptive etiology in the majority of cases of chronic low back pain (CLBP). More recent study and treatments have discovered that the vertebral endplates play a large role in CLBP in a term defined as vertebrogenic back pain. As the vertebral endplates are highly innervated via the basivertebral nerve (BVN), this has resulted in a reliable target in treating patients suffering from vertebrogenic low back pain (VLBP). The application of BVN ablation for patients suffering from VLBP is still in its early stages of adoption and integration into spine care pathways. BVN ablation is grounded in a solid foundation of both pre-clinical and clinical evidence. With the emergence of this therapeutic option, the American Society of Pain and Neuroscience (ASPN) identified the need for formal evidence-based guidelines for the proper identification and selection of patients for BVN ablation in patients with VLBP. ASPN formed a multidisciplinary work group tasked to examine the available literature and form best practice guidelines on this subject. Based on the United States Preventative Task Force (USPSTF) criteria for grading evidence, gives BVN ablation Level A grade evidence with high certainty that the net benefit is substantial in appropriately selected individuals.

摘要

慢性下腰痛是全球疼痛和残疾的主要原因。在大多数慢性下腰痛(CLBP)病例中,椎间盘退变疾病一直被认为是病因。最近的研究和治疗发现,椎体终板在一种被定义为椎源性背痛的慢性下腰痛中起很大作用。由于椎体终板通过椎基底神经(BVN)高度神经化,这为治疗椎源性下腰痛(VLBP)患者提供了一个可靠的靶点。BVN消融术在VLBP患者中的应用仍处于早期采用阶段,尚未完全融入脊柱护理路径。BVN消融术有坚实的临床前和临床证据基础。随着这种治疗选择的出现,美国疼痛与神经科学学会(ASPN)确定需要制定基于正式证据的指南,以便在VLBP患者中正确识别和选择适合进行BVN消融术的患者。ASPN成立了一个多学科工作组,负责审查现有文献并制定关于该主题的最佳实践指南。根据美国预防服务工作组(USPSTF)的证据分级标准,BVN消融术被评为A级证据,高度确定在适当选择的个体中净效益显著。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5005/9482788/cb96794af837/JPR-15-2801-g0016.jpg
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Prospective, randomized, multicenter study of intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: 24-Month treatment arm results.

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Developments in Minimally Invasive Surgical Options for Vertebral Pain: Basivertebral Nerve Ablation - A Narrative Review.

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Prospective, randomized, multicenter study of intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: 12-month results.

Reg Anesth Pain Med. 2021-8

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The Effectiveness of Intraosseous Basivertebral Nerve Radiofrequency Neurotomy for the Treatment of Chronic Low Back Pain in Patients with Modic Changes: A Systematic Review.

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