First Three-Level Ablation of the Basivertebral Nerve in Spain

First three-level ablation of the basivertebral nerve combined with LR-PRP in the Iberian Peninsula: A new surgical technique

On November 19, 2024, for the first time in Spain, Dr. Ricardo Ruiz-López (CLÍNICA VERTEBRA, SpinePain & Regenerative SURGERY CENTERS) performed a non-invasive radiofrequency ablation of the basivertebral nerve in three vertebrae, combined with the instillation of Platelet-Rich Plasma (LR-PRP). Radiofrequency ablation of the basivertebral nerve has recently been implemented in the USA, but only one previous surgery has been reported in Spain, performed at two levels by Dr. Abejón (Hospital Quirónsalud Juan Bravo, Madrid) [1, 2].

The patient suffered from vertebrogenic pain with Modic I changes and had previously received unsuccessful treatment (radiofrequency denervation of medial branches of the facet joints, analgesia, and anti-inflammatory medications). A minimally invasive procedure was performed at three levels on the L4–L5–S1 vertebrae, using a left transpedicular approach with Vertiblate™ technology. Bipolar radiofrequency was applied at 60°C for 6 minutes. As an adjunct, a Leukocyte-Rich PRP solution contrasted with iohexol, extracted from 120 mL of the patient’s own blood and distributed homogeneously in the treated vertebrae, was instilled intrasomatically at each vertebral level. Following the procedure, the patient is recovering at home, which is proceeding without complications. Dr. Ruiz-López’s team will continue to report on the patient’s progress, and the case is expected to be published in future scientific journals, illustrating the clinical case in detail.

We would like to thank our collaborators, Dr. Ricardo Dorado (Stimhealth Medical) and Dr. Bruno Lourenço Costa (expert in the technique), as well as the patient, for entrusting the Vertebra Clinic team with this procedure, which we hope will help us treat other patients with similar conditions in the future. We will continue learning, improving, and offering effective therapies to our patients.

[2] David Abejón Pain Unit. “First case of ablative radiofrequency ablation of the basivertebral nerve in Spain” (July 20, 2024) https://davidabejon.com/radiofrecuencia-ablativa-del-nervio-basivertebra-en-espana/

[1] Fischgrund JS, Rhyne A, Franke J, Sasso R, Kitchel S, Bae H, Yeung C, Truumees E, Schaufele M, Yuan P, Vajkoczy P. Intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: a prospective randomized double-blind sham-controlled multi-center study. European Spine Journal. 2018 May;27:1146-56.