Low Back Pain-related Healthcare Utilization following Intraosseous Basivertebral Nerve Radiofrequency Ablation: A Pooled Analysis from Three Prospective Clinical Trials.
Modic changes
basivertebral nerve
chronic low back pain
disc
radiofrequency ablation
vertebrogenic pain
Journal
Pain medicine (Malden, Mass.)
ISSN: 1526-4637
Titre abrégé: Pain Med
Pays: England
ID NLM: 100894201
Informations de publication
Date de publication:
29 Aug 2023
29 Aug 2023
Historique:
received:
29
06
2023
revised:
21
08
2023
accepted:
21
08
2023
medline:
30
8
2023
pubmed:
30
8
2023
entrez:
29
8
2023
Statut:
aheadofprint
Résumé
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. 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. 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. 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.
Sections du résumé
BACKGROUND
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
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
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
CONCLUSIONS
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.
Identifiants
pubmed: 37643639
pii: 7254486
doi: 10.1093/pm/pnad114
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© The Author(s) 2023. Published by Oxford University Press on behalf of the American Academy of Pain Medicine.