Stephens Andrew R, Aktas Adem F, El-Hassan Ramzi
University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY, 14623, United States of America.
Interv Pain Med. 2025 May 30;4(2):100594. doi: 10.1016/j.inpm.2025.100594. eCollection 2025 Jun.
Basivertebral nerve radiofrequency ablations (BVNRFA) have shown efficacy in improving chronic back pain for indicated patients.
The purpose of this study was to evaluate health care utilization outcomes after BVNRFA in a large cohort utilizing a global database.
TriNetX, a global health research network, was queried from 2022 to 2025 for patients who underwent BVNRFA utilizing CPT codes and 1 year pre-procedure and post-procedure opioid use and spine interventions were recorded. Pre-procedure and post-procedure outcomes were compared using a chi-square test with significance set at p < 0.05. The rate of spine surgery within 1 year after BVNRFA was also reported.
A total of 1,118 patients underwent BVNRFA during this time frame at contributing health care systems with appropriate follow-up. Post-procedure opioid use was less than pre-procedure opioid use (57 % vs 51 %, p = 0.006). The number of patients who received spine interventions after BVNRFA were significantly lower compared to patients who received spine interventions prior with lumbar transforaminal epidural steroid injections decreasing from 21 % to 12 % (p < 0.001), lumbar interlaminar steroid injections decreasing from 18 % to 11 % (p < 0.001), and radiofrequency ablations decreasing from 25 % to 13 % (p < 0.001). Only 47 patients had CPT codes related to post-procedure vertebral column spine surgery. Specifically, there were 11 patients who had CPT codes for posterior lumbar fusion (CPT 22630), 10 had lateral lumbar fusion (CPT 22533), and 10 had anterior codes (CPT 22558). There were 0 patients who underwent total disc replacement (CPT 22857).
This administrative database study demonstrated significantly less opioid use and spine interventions within 1 year after BVNRFA compared to 1 year prior. This study also demonstrated low rates of spine surgery within 1 year after BVNRFA.
椎基神经射频消融术（BVNRFA）已显示出对特定患者改善慢性背痛的疗效。
本研究的目的是利用一个全球数据库评估大型队列中BVNRFA后的医疗保健利用结果。
从2022年至2025年对全球健康研究网络TriNetX进行查询，以获取接受BVNRFA的患者，使用CPT编码记录术前1年和术后1年的阿片类药物使用情况及脊柱干预措施。使用卡方检验比较术前和术后结果，显著性设定为p < 0.05。还报告了BVNRFA后1年内脊柱手术的发生率。
在此时间段内，共有1118名患者在提供医疗服务的系统中接受了BVNRFA并得到了适当的随访。术后阿片类药物使用少于术前（57%对51%，p = 0.006）。与术前接受脊柱干预的患者相比，BVNRFA后接受脊柱干预的患者数量显著减少，腰椎经椎间孔硬膜外类固醇注射从21%降至12%（p < 0.001），腰椎椎板间类固醇注射从18%降至11%（p < 0.001），射频消融从25%降至13%（p < 0.001）。只有47名患者的CPT编码与术后脊柱手术相关。具体而言，有11名患者的CPT编码为后路腰椎融合术（CPT 22630），10名患者为侧路腰椎融合术（CPT 22533），10名患者为前路手术（CPT 22558）。没有患者接受全椎间盘置换术（CPT 22857）。
这项管理数据库研究表明，与术前1年相比，BVNRFA后1年内阿片类药物使用和脊柱干预显著减少。本研究还表明BVNRFA后1年内脊柱手术发生率较低。
