• Aaron Conger, Taylor R Burnham, Tyler Clark, Masaru Teramoto, and Zachary L McCormick.
• Division of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, Utah, USA.
• Pain Med. 2022 Jul 20; 23 (Suppl 2): S50-S62.

ObjectiveTo provide an estimate of the effectiveness of basivertebral nerve (BVN) radiofrequency ablation (RFA) to treat vertebrogenic low back pain (LBP).DesignSystematic review with single-arm meta-analysis.PopulationPersons ≥18 years of age with chronic LBP associated with type 1 or 2 Modic changes.InterventionIntraosseous BVN RFA.ComparisonSham, placebo procedure, active standard care treatment, or none.OutcomesThe proportion of patients treated with BVN RFA who reported ≥50% pain score improvement on a visual analog scale or numeric rating scale. The main secondary outcome was ≥15-point improvement in Oswestry Disability Index score.MethodsThree reviewers independently assessed articles published before December 6, 2021, in MEDLINE and Embase. The Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) framework was used to evaluate the overall quality of evidence.ResultsOf the 856 unique records screened, 12 publications met the inclusion criteria, representing six unique study populations, with 414 participants allocated to receive BVN RFA. Single-arm meta-analysis showed a success rate of 65% (95% confidence interval [CI] 51-78%) and 64% (95% CI 43-82%) for ≥50% pain relief at 6 and 12 months, respectively. Rates of ≥15-point Oswestry Disability Index score improvement were 75% (95% CI 63-86%) and 75% (95% CI 63-85%) at 6 and 12 months, respectively.ConclusionAccording to GRADE, there is moderate-quality evidence that BVN RFA effectively reduces pain and disability in most patients with vertebrogenic LBP. Further high-quality studies will likely improve our understanding of the effectiveness of this procedure.© The Author(s) 2022. Published by Oxford University Press on behalf of the American Academy of Pain Medicine.

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