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Lumbar Degenerative Disease Part 1: Anatomy and Pathophysiology of Intervertebral Discogenic Pain and Radiofrequency Ablation of Basivertebral and Sinuvertebral Nerve Treatment for Chronic Discogenic Back Pain: A Prospective Case Series and Review of Literature

by Hyeun Sung Kim 1,*,†, Pang Hung Wu 1,2,† and Il-Tae Jang 1
1
Nanoori Gangnam Hospital, Seoul, Spine Surgery, Seoul 06048, Korea
2
National University Health Systems, Juronghealth Campus, Orthopaedic Surgery, Singapore 609606, Singapore
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Int. J. Mol. Sci. 2020, 21(4), 1483; https://doi.org/10.3390/ijms21041483
Received: 31 January 2020 / Revised: 17 February 2020 / Accepted: 20 February 2020 / Published: 21 February 2020
(This article belongs to the Section Molecular Pathology, Diagnostics, and Therapeutics)
Degenerative disc disease is a leading cause of chronic back pain in the aging population in the world. Sinuvertebral nerve and basivertebral nerve are postulated to be associated with the pain pathway as a result of neurotization. Our goal is to perform a prospective study using radiofrequency ablation on sinuvertebral nerve and basivertebral nerve; evaluating its short and long term effect on pain score, disability score and patients’ outcome. A review in literature is done on the pathoanatomy, pathophysiology and pain generation pathway in degenerative disc disease and chronic back pain. 30 patients with 38 levels of intervertebral disc presented with discogenic back pain with bulging degenerative intervertebral disc or spinal stenosis underwent Uniportal Full Endoscopic Radiofrequency Ablation application through either Transforaminal or Interlaminar Endoscopic Approaches. Their preoperative characteristics are recorded and prospective data was collected for Visualized Analogue Scale, Oswestry Disability Index and MacNab Criteria for pain were evaluated. There was statistically significant Visual Analogue Scale improvement from preoperative state at post-operative 1wk, 6 months and final follow up were 4.4 ± 1.0, 5.5 ± 1.2 and 5.7 ± 1.3, respectively, p < 0.0001. Oswestery Disability Index improvement from preoperative state at 1week, 6 months and final follow up were 45.8 ± 8.7, 50.4 ± 8.2 and 52.7 ± 10.3, p < 0.0001. MacNab criteria showed excellent outcomes in 17 cases, good outcomes in 11 cases and fair outcomes in 2 cases Sinuvertebral Nerve and Basivertebral Nerve Radiofrequency Ablation is effective in improving the patients’ pain, disability status and patient outcome in our study. View Full-Text
Keywords: degenerative disc disease; lumbar spondylosis; pain management; sinuvertebral nerve; basivertebral nerve; discogenic back pain; pathophysiology of back pain; endoscopic spine surgery; radiofrequency ablation; prolapsed intervertebral disc degenerative disc disease; lumbar spondylosis; pain management; sinuvertebral nerve; basivertebral nerve; discogenic back pain; pathophysiology of back pain; endoscopic spine surgery; radiofrequency ablation; prolapsed intervertebral disc
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Kim, H.S.; Wu, P.H.; Jang, I.-T. Lumbar Degenerative Disease Part 1: Anatomy and Pathophysiology of Intervertebral Discogenic Pain and Radiofrequency Ablation of Basivertebral and Sinuvertebral Nerve Treatment for Chronic Discogenic Back Pain: A Prospective Case Series and Review of Literature. Int. J. Mol. Sci. 2020, 21, 1483.

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