Transforaminal Epiduroscopic Basivertebral Nerve Laser Ablation for Chronic Low Back Pain Associated with Modic Changes: A Preliminary Open-Label Study

Abstract EN

Background.

Chronic low back pain (CLBP) arising from degenerative disc disease continues to be a challenging clinical and diagnostic problem whether treated with nonsurgical, pain intervention, or motion-preserving stabilization and arthrodesis.

Methods.

Fourteen patients with CLBP, greater than 6 months, unresponsive to at least 4 months of conservative care were enrolled.

All patients were treated successfully following screening using MRI findings of Modic type I or II changes and positive confirmatory provocative discography to determine the affected levels.

All patients underwent ablation of the basivertebral nerve (BVN) using 1414 nm Nd:YAG laser-assisted energy guided in a transforaminal epiduroscopic approach.

Macnab’s criteria and visual analog scale (VAS) score were collected retrospectively at each follow-up interval.

Results.

The mean age was 46 ± 9.95 years.

The mean symptoms duration was 21.21 ± 21.87 months.

The mean follow-up was 15.3 ± 2.67 months.

The preoperative VAS score of 7.79 ± 0.97 changed to 1.92 ± 1.38, postoperatively (P<0.01).

As per Macnab’s criteria, seven patients (50%) had excellent, six patients (42.85%) had good, and one patient (7.14%) had fair outcomes.

Conclusion.

The transforaminal epiduroscopic basivertebral nerve laser ablation (TEBLA) appears to be a promising option in carefully selected patients with CLBP associated with the Modic changes.