03/12/2023
Vertebrogenic Pain: A Paradigm Shift in Diagnosis and Treatment of Axial Low Back Pain
Aaron Conger, DO, Matthew Smuck, MD, Eeric Truumees, MD, Jeffrey C Lotz, PhD, Michael J DePalma, MD, Zachary L McCormick, MD
Pain Medicine, Volume 23, Issue Supplement_2, August 2022, Pages S63–S71, https://doi.org/10.1093/pm/pnac081
Published: 20 July 2022
Summary
Accumulated damage to the discovertebral complex may result in chemical and mechanical sensitization of endplate nocioceptors resulting in chronic vertebrogenic LBP.
Midline LBP, pain exacerbation by physical activity, sitting, and forward flexion are factors associated with treatment success after BVN RFA.
In appropriately selected patients, BVN RFA results in substantial reduction in pain and disability in the majority of those treated at 12 months, with similar long term outcomes at 5 years.
The presence of MC1 or MC2 is currently the best radiographic indicator of vertebrogenic pain. Outcomes after BVN RFA are not impacted by the volume of MC, location of MC, degree of disc degeneration, or presence/size of endplate defects. Patients with MC1 vs MC2 experience similar rates of success after BVN RFA.
Clinicians are encouraged to select patients for BVN RFA based upon the clinical and radiographic criteria used in published studies to date.
In 1966, an article reported that the source of chronic low back pain (CLBP) could not be identified in 79% of male and 89% of female patients from a general pr