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Low Back Pain-related Healthcare Utilization following Intraosseous Basivertebral Nerve Radiofrequency Ablation: A Pooled Analysis from Three Prospective Clinical Trials – Lumbar Fusion

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The article discusses the effectiveness and safety of intraosseous basivertebral nerve ablation (BVNA) for treating vertebrogenic pain. The study pooled data from three prospective studies to evaluate low back pain-related healthcare utilization (LBPr-HU) following BVNA. The categories of LBPr-HU analyzed included non-invasive conservative care, opioid utilization, lumbosacral spinal injection (LSI), lumbosacral radiofrequency ablation (LRFA), and lumbosacral spinal surgery. The results showed a significant reduction in the utilization of conservative care, opioids, LSIs, and LRFA up to five years after BVNA compared to baseline. Lumbar fusion rates were also lower than the published rates for similar populations. Overall, the study highlights the long-term benefits of BVNA in reducing low back pain-related healthcare utilization

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : top spinal hospital in London

Published article

CONCLUSION: In this aggregate analysis of patients with vertebrogenic pain, utilization of conservative care, opioids, LSIs, and LRFA were substantially reduced through five years post-BVNA compared to baseline. Lumbar fusion rates were less than half the published value at five years in similar populations.

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Pain Med. 2023 Aug 29:pnad114. doi: 10.1093/pm/pnad114. Online ahead of print.ABSTRACTBACKGROUND: The effectiveness and safety of intraosseous basivertebral nerve ablation (BVNA) for treating vertebrogenic pain is established, but low back pain-related healthcare utilization (LBPr-HU) following BVNA continues to be defined.METHODS: LBPr-HU data were pooled from three prospective studies. LBPr-HU categories of interest included non-invasive conservative,

Pain Med. 2023 Aug 29:pnad114. doi: 10.1093/pm/pnad114. Online ahead of print.

ABSTRACT

BACKGROUND: The effectiveness and safety of intraosseous basivertebral nerve ablation (BVNA) for treating vertebrogenic pain is established, but low back pain-related healthcare utilization (LBPr-HU) following BVNA continues to be defined.

METHODS: LBPr-HU data were pooled from three prospective studies. LBPr-HU categories of interest included non-invasive conservative care, opioid utilization, lumbosacral spinal injection (LSI), lumbosacral radiofrequency ablation (LRFA), and lumbosacral spinal surgery. Pre- and post-BVNA LBPr-HU were compared at both one- and five-years using McNemar’s test for proportions and paired t-tests for means.

RESULTS: Two hundred forty-seven patients received BVNA and had one-year follow-up; 205 had long-term follow-up (mean of 5.3 ± 1.33 years). Twenty-seven percent fewer participants initiated conservative care in the year post-BVNA compared to the year preceding BVNA (p < 0.001; 95%CI 19.8-34.5). Of 77/247 participants taking opioids at baseline, 40.3% and 61.7% fewer were taking them at one-year and 5.3 ± 1.33 years post-BVNA, respectively (p < 0.001). Of participants receiving LSIs in the year preceding BVNA, 81.2% fewer received LSI(s) in the year post-BVNA (p < 0.001; 95%CI 70.7-90.7); a 76.4% reduction in LSIs was maintained through a mean of 5.3 ± 1.33 years post-BVNA. LRFA rates were 1.6% at one-year post-BVNA and 8.3% at 5.3 ± 1.33 years post-BVNA. Lumbar fusion surgery was 0.8% at one-year post-BVNA and 6.5% at 5.3 ± 1.33 years post-BVNA.

CONCLUSION: In this aggregate analysis of patients with vertebrogenic pain, utilization of conservative care, opioids, LSIs, and LRFA were substantially reduced through five years post-BVNA compared to baseline. Lumbar fusion rates were less than half the published value at five years in similar populations.

PMID:37643639 | DOI:10.1093/pm/pnad114

The London Spine Unit : top spinal hospital in London

Read the original publication:

Low Back Pain-related Healthcare Utilization following Intraosseous Basivertebral Nerve Radiofrequency Ablation: A Pooled Analysis from Three Prospective Clinical Trials

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Pain Med. 2023 Aug 29:pnad114. doi: 10.1093/pm/pnad114. Online ahead of print.ABSTRACTBACKGROUND: The effectiveness and safety of intraosseous basivertebral nerve ablation (BVNA) for treating vertebrogenic pain is established, but low back pain-related healthcare utilization (LBPr-HU) following BVNA continues to be defined.METHODS: LBPr-HU data were pooled from three prospective studies. LBPr-HU categories of interest included non-invasive conservative
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