WikiMSK:Featured Journal Article/1 May 2025

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Featured Open Access Journal Article for 1 April 2025

Intraosseous basivertebral nerve ablation: A 5-year pooled analysis from three prospective clinical trials

Interventional Pain Medicine

ABSTRACT - Vertebrogenic pain, caused by damaged vertebral endplates and transmitted via the basivertebral nerve (BVN), is linked to chronic low back pain (CLBP) and is identifiable by Modic changes on MRI. Intraosseous radiofrequency ablation of the BVN (BVNA) has previously shown clinical benefit in three prospective studies.

This report aggregates 5-year follow-up outcomes from those three trials. Out of 320 BVNA-treated patients, 249 (78%) completed 5-year follow-up (mean 5.6 years). Key baseline characteristics: 71.9% had back pain โ‰ฅ5 years, 27.7% used opioids, 61.8% had prior spinal injections.

Results at 5 years:

  • Pain (NPS) improved by a mean of 4.32 points (p < 0.0001).
  • Disability (ODI) improved by a mean of 28 points (p < 0.0001).
  • 32.1% of patients were pain-free.
  • 72.7% reported improvement; 68.7% resumed pre-CLBP activity levels.
  • Of the opioid users at baseline, 65.2% had stopped opioids.
  • Spinal injections reduced by 58.1%.
  • 13.2% underwent further lumbosacral interventions, including 6% lumbar fusion.
  • No serious device-related adverse events were reported.
Conclusion: BVNA shows durable and significant improvements in pain, function, and opioid reduction over 5 years, with a strong safety profile.

BVNA_pooled_analysis_-_Khalil_2024.pdf
Full Text - 2.16 MB (f)

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