Abstract
Objective. To evaluate the efficacy and safety of radiofrequency ablation of the basivertebral nerve in the treatment of chronic low back pain associated with Modic I and II changes according to MRI data.Material and Methods. The results of treatment of 19 patients with chronic low back pain syndrome in the lower back lasting 6 months or more were analyzed. Patients were treated with radiofrequency ablation of basivertebral nerve.Results. The duration of the manipulation averaged 28.0 ± 4.8 min. In all patients, a decrease in the Oswestry index by an average of 24.3 points (21.7 ± 5.2) was observed at 6 months after ablation of the basivertebral nerve. The intensity of the pain syndrome decreased immediately after the manipulation to 2.1 ± 1.1 cm on average, that is, by 71.2 %. According to the Beck Depression Scale, the patients showed signs of mild depression (subdepression) before the procedure (13.8 ± 3.6 points). When examined after 12 months, the patients showed an improvement in their psychoemotional state up to the normal values (3.4 ± 2.7 points). Subjective assessment of the condition of patients compared with the baseline showed that 16 (84.2 %) of them assessed their condition as a significant improvement with a significant regression of pain by more than 50 % at all stages of follow-up, and two patients (10.5 %) reported only a slight decrease in pain syndrome immediately after the procedure, followed by its resumption to the initial level.Conclusion. Using clear criteria for selection of patients for radiofrequency ablation of the basivertebral nerve, it can be argued that this method is effective in the treatment of chronic low back pain associated with Modic I and II changes according to MRI data. With the help of radiofrequency ablation, it is possible to achieve long-term remission of pain syndrome up to 12 months and more.
Highlights
Using clear criteria for selection of patients for radiofrequency ablation of the basivertebral nerve, it can be argued that this method is effective in the treatment of chronic low back pain associated with Modic I and II changes according to MRI data
Проанализированы результаты лечения 19 пациентов (12 мужчин и 7 женщин) в возрасте 52,6 ± 6,9 года с хроническим болевым синдром в пояснице методом радиочастотной абляции базивертебрального нерва
При четких критериях отбора пациентов радиочастотная абляция базивертебрального нерва является эффективным методом лечения хронического болевого синдрома в пояснице, ассоциируемого с изменениями по типу Modic I и II (по данным МРТ)
Summary
To evaluate the efficacy and safety of radiofrequency ablation of the basivertebral nerve in the treatment of chronic low back pain associated with Modic I and II changes according to MRI data. The results of treatment of 19 patients with chronic low back pain syndrome in the lower back lasting 6 months or more were analyzed. A decrease in the Oswestry index by an average of 24.3 points (21.7 ± 5.2) was observed at 6 months after ablation of the basivertebral nerve. The intensity of the pain syndrome decreased immediately after the manipulation to 2.1 ± 1.1 cm on average, that is, by 71.2 %. Subjective assessment of the condition of patients compared with the baseline showed that 16 (84.2 %) of them assessed their condition as a significant improvement with a significant regression of pain by more than 50 % at all stages of follow-up, and two patients (10.5 %) reported only a slight decrease in pain syndrome immediately after the procedure, followed by its resumption to the initial level
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