Based on the analysis of the published literature, the time-related unfolding of clinical manifestations of the onset and course of pain vertebrogenic syndromes, using morphofunctional, thus, anatomo-topical principles of development and spread of the pathology, the authors have substantiated causes of its origination as well as their own conceptions regarding mechanisms of formation. The secured results permit using pathogenetically validated differentiated methods of treatment in certain kinds of pain vertebrogenic syndromes from the standpoint of cause and effect correlations with respect to their origination.
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Intraosseous basivertebral nerve ablation: A 5-year pooled analysis from three prospective clinical trials.
Interv Pain Med
December 2024
Department of Orthopaedic Surgery, William Beaumont University Hospital, 3811 West 13 Mile Rd, Royal Oak, MI, USA.
Article Synopsis
- Vertebrogenic pain, often linked to damage in vertebral endplates, is transmitted through the basivertebral nerve (BVN) and is associated with Modic changes visible on MRI.
- A five-year follow-up of three clinical trials assessing intraosseous radiofrequency ablation (BVNA) shows significant pain and functional improvement in patients with chronic low back pain.
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Prospective cohort study of basivertebral nerve ablation for chronic low back pain in a real-world setting: 12 months follow-up.
Interv Pain Med
December 2024
Nova Southeastern University, College of Allopathic Medicine, Fort Lauderdale, FL, USA.
Background: The basivertebral nerve, which densely supplies the vertebral endplates, is a potential source of chronic low back pain transmission in patients with Modic changes. Basivertebral nerve ablation (BVNA), a minimally invasive procedure, aims to disrupt this pain signaling.
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Preclinical development and characterisation of PP353, a formulation of linezolid for intradiscal administration.
JOR Spine
December 2024
Persica Pharmaceuticals Ltd Kent UK.
Introduction: Bacterial infection of the intervertebral disc can lead to vertebral endplate edema known as Modic changes, with associated chronic low back pain. Oral antimicrobial therapy has shown efficacy but relies on prolonged dosing and may not be optimal in terms of patient outcome, side effects, or antibiotic stewardship. There is no antibiotic formulation approved for intradiscal administration.
View Article and Find Full Text PDFPharmacokinetics of PP353, a formulation of linezolid for intervertebral disc administration, in patients with chronic low back pain and Modic change Type 1: A first-in-human, Phase 1b, open-label, single-dose study.
JOR Spine
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Persica Pharmaceuticals Ltd Canterbury Kent UK.
Background: Bacterial infection of the intervertebral disc is difficult to treat because the tissue is usually not vascularized and systemic antibiotic therapy may not reach optimal antibacterial exposure. Here we characterize the safety, tolerability, and pharmacokinetics of PP353, a suspension of micronized linezolid, formulated for direct intervertebral disc administration.
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Minimally invasive treatments for chronic low back pain.
JAAPA
December 2024
At the time this article was written, Chelsey M. Hoffmann was academic co-director of the PA program at the Mayo Clinic School of Health Science in Rochester, Minn. She now practices in the Department of Pain Medicine, Division of Anesthesiology, at the Mayo Clinic in Rochester, Minn. Ryan Mattie practices at Total Spine Institute in Los Angeles, Calif. Samir J. Sheth practices at Sutter Health in Roseville, Calif. Ryan S. D'Souza is director of neuromodulation and a consultant in the Department of Pain Medicine, Division of Anesthesiology, at the Mayo Clinic. Ms. Hoffmann discloses that she provides general consulting for SPR Therapeutics and Nalu Medical. Dr. Sheth is a consultant for SPR, Medtronic, Boston Scientific, and Vertos. Dr. D'Souza has an investigator-initiated grant with Nevro Corp. The authors have disclosed no other potential conflicts of interest, financial or otherwise.
This article describes minimally invasive treatments for managing chronic low back pain (LBP) related to lumbar spinal stenosis, facetogenic LBP, vertebrogenic LBP, or discogenic LBP. We also propose a clinical decision-making tool to guide clinicians in appropriate patient selection for various treatments.
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