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