Basivertebral Nerve Radiofrequency Ablation for Vertebral Osteomyelitis: A Technical Report.

Pain medicine case reports Pub Date : 2026-07-01

Jimmy Wen, Allyson Kouche, Megan Kou, Yu-Tung Chen, Jose Silva, Sugamjot Badhan, Arsh Alam, Foad Elahi

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Abstract

Background: Vertebral osteomyelitis (VO) frequently results in persistent vertebrogenic back pain (VBP) due to ongoing endplate inflammation and structural damage despite infection-directed therapy. The application of basivertebral nerve radiofrequency ablation (BVNRFA) for VBP resulting from vertebral infection has not been explored in the current literature.

Case report: A 53-year-old man with poorly controlled diabetes and recurrent L3-L4 osteomyelitis underwent multiple hospitalizations for sepsis and progressive vertebral body destruction. Serial magnetic resonance imaging demonstrated chronic L3-L4 osteomyelitis with marrow edema, and 2 persistent enhancing fluid pockets, but no surgically drainable epidural abscess. Despite prolonged intravenous antibiotics and the absence of operative indications, severe axial lumbar pain continued with significant functional limitation. BVNRFA was performed to target nociceptive signaling originating from chronically diseased vertebral endplates. The intervention was tolerated without complications and resulted in meaningful improvement in axial pain and mobility.

Conclusion: Our case illustrates a novel application of BVNRFA for VBP associated with chronic VO.

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椎体神经射频消融术治疗椎体骨髓炎：一份技术报告。

背景：椎体骨髓炎（VO）经常导致持续的椎体源性背痛（VBP），这是由于持续的终板炎症和结构损伤，尽管有感染定向治疗。椎体神经射频消融术（bas椎神经射频消融术）治疗椎体感染引起的VBP的应用尚未见文献报道。病例报告：一名53岁男性糖尿病控制不良并复发L3-L4骨髓炎，因败血症和进行性椎体破坏多次住院。连续磁共振成像显示慢性L3-L4级骨髓炎伴骨髓水肿，2个持续强化的液体袋，但无手术可引流的硬膜外脓肿。尽管长时间静脉注射抗生素和没有手术指征，严重的轴向腰痛持续存在明显的功能限制。BVNRFA是针对慢性病变椎终板产生的伤害性信号。干预是耐受的，无并发症，导致轴向疼痛和活动能力有意义的改善。结论：我们的病例说明了BVNRFA在慢性VO相关VBP中的新应用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Pain medicine case reports

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