Schnapp William, Martiatu Kenneth, Delcroix Gaëtan J-R
NeuroSpine & Pain Center, Key West, FL, USA.
Nova Southeastern University, College of Allopathic Medicine, Fort Lauderdale, FL, USA.
N Am Spine Soc J. 2023 Jan 29;14:100201. doi: 10.1016/j.xnsj.2023.100201. eCollection 2023 Jun.
Strong innervation of the vertebral endplates by the basivertebral nerve makes it an ideal target for ablation in the treatment of vertebrogenic low back pain with Modic changes. This data represents the clinical outcomes for 16 consecutively treated patients in a community practice setting.
Basivertebral nerve ablations were performed on 16 consecutive patients by a single surgeon (WS) utilizing the INTRACEPT® device (Relievant Medsystems, Inc.). Evaluations were performed at baseline, 1 month, 3 months, and 6 months. The Oswestry Disability Index (ODI), Visual Analog Scale (VAS), and SF-36 were recorded in Medrio electronic data capture software. All patients ( = 16) completed the baseline, 1 month, 3 months, and 6 months follow-up.
The ODI, VAS, and SF-36 Pain Component Summary showed statistically significant improvements above minimal clinically important differences at 1 month, 3 months, and 6 months (all p values <0.05). Change in ODI pain impact declined 13.1 points [95% CI: 0.01,27.2] at one month from baseline, 16.5 points [95% CI: 2.5,30.6] at three months from baseline, and 21.1 points [95% CI: 7.0,35.2] six-months from baseline. SF-36 Mental Component Summary also showed some improvements, but with significance only at 3 months ( = 0.0091).
Basivertebral nerve ablation appears to be a durable, minimally invasive treatment for the relief of chronic low back pain that can be successfully implemented in a community practice setting. To our knowledge, this is the first independently funded US study on basivertebral nerve ablation.
椎体静脉神经对椎体终板的强大神经支配使其成为治疗伴有Modic改变的椎源性下腰痛时进行消融的理想靶点。本数据代表了在社区实践环境中连续治疗的16例患者的临床结果。
由单一外科医生(WS)使用INTRACEPT®设备(Relievant Medsystems公司)对16例连续患者进行椎体静脉神经消融。在基线、1个月、3个月和6个月时进行评估。Oswestry功能障碍指数(ODI)、视觉模拟量表(VAS)和SF-36在Medrio电子数据采集软件中记录。所有患者(n = 16)均完成了基线、1个月、3个月和6个月的随访。
ODI、VAS和SF-36疼痛分量表总结显示,在1个月、3个月和6个月时,在最小临床重要差异之上有统计学显著改善(所有p值<0.05)。ODI疼痛影响变化在基线后1个月下降13.1分[95%可信区间:0.01,27.2],基线后3个月下降16.5分[95%可信区间:2.5,30.6],基线后6个月下降21.1分[95%可信区间:7.0,35.2]。SF-36心理分量表总结也显示了一些改善,但仅在3个月时有显著性(p = 0.0091)。
椎体静脉神经消融似乎是一种持久、微创的治疗慢性下腰痛的方法,可在社区实践环境中成功实施。据我们所知,这是美国第一项关于椎体静脉神经消融的独立资助研究。