Fluoroscopic-guided radiofrequency ablation of the basivertebral nerve: application and analysis with multiple imaging modalities in an ovine model.

摘要

Pathologic involvement of the basivertebral nerve, an intraosseous vertebral nerve found in humans and mostmammalian species, may play a role in some forms of back pain1, 2. This study was designed to assess the feasibility andeffects of the percutaneous delivery of radiofrequency (RF) energy to thermally ablate the basivertebral nerve in thelumbar vertebrae of mature sheep. Using fluoroscopic guidance, a RF bipolar device was placed and a thermal dosedelivered to lumbar vertebral bodies in sheep. Post-treatment assessment included multiple magnetic resonance imaging(MRI) techniques and computed tomography (CT). These data were analyzed and correlated to histopathology andmorphometry findings to describe the cellular and boney structural changes resulting from the treatment. Imagingmodalities MRI and CT can be implemented to non-invasively describe treatment region and volume, marrow cellulareffects, and bone density alterations immediately following RF treatment and during convalescence. Such imaging canbe utilized to assess treatment effects and refine the thermal dose to vertebral body volume ratio used in treatmentplanning. This information will be used to improve the therapeutic ratio and develop a treatment protocol for humanapplications.