• Hyeun Sung Kim, Nitin Adsul, Farid Yudoyono, Byapak Paudel, Ki Joon Kim, Sung Ho Choi, Jeong Hoon Kim, Sung Kyun Chung, Jeong-Hoon Choi, Jee-Soo Jang, Il-Tae Jang, and Seong-Hoon Oh.
• Department of Neurosurgery, Nanoori Suwon Hospital, Suwon, Republic of Korea.
• Pain Res Manag. 2018 Jan 1; 2018: 6857983.

BackgroundChronic low back pain (CLBP) arising from degenerative disc disease continues to be a challenging clinical and diagnostic problem whether treated with nonsurgical, pain intervention, or motion-preserving stabilization and arthrodesis.MethodsFourteen patients with CLBP, greater than 6 months, unresponsive to at least 4 months of conservative care were enrolled. All patients were treated successfully following screening using MRI findings of Modic type I or II changes and positive confirmatory provocative discography to determine the affected levels. All patients underwent ablation of the basivertebral nerve (BVN) using 1414 nm Nd:YAG laser-assisted energy guided in a transforaminal epiduroscopic approach. Macnab's criteria and visual analog scale (VAS) score were collected retrospectively at each follow-up interval.ResultsThe mean age was 46 ± 9.95 years. The mean symptoms duration was 21.21 ± 21.87 months. The mean follow-up was 15.3 ± 2.67 months. The preoperative VAS score of 7.79 ± 0.97 changed to 1.92 ± 1.38, postoperatively (P < 0.01). As per Macnab's criteria, seven patients (50%) had excellent, six patients (42.85%) had good, and one patient (7.14%) had fair outcomes.ConclusionThe transforaminal epiduroscopic basivertebral nerve laser ablation (TEBLA) appears to be a promising option in carefully selected patients with CLBP associated with the Modic changes.

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