First Three-Level Basivertebral Nerve Ablation in Spain

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

On 19.11.2024, for the first time in Spain, Dr. Ricardo Ruiz-López (CLÍNICA VERTEBRA, SpinePain & Regenerative SURGERY CENTERS) performed a non-invasive radiofrequency basivertebral nerve ablation in three vertebrae, combined with the instillation of Platelet Rich Plasma (LR-PRP). Radiofrequency for basivertebral nerve ablation has recently been implemented in the USA, but only one previous surgery has been reported in Spain performed on two levels by Dr. Abejón (Quirónsalud Juan Bravo Hospital, Madrid) [1, 2].

The patient suffered from vertebrogenic pain with Modic I changes and had been unsuccessfully treated (radiofrequency facet denervation of medial branches, analgesia, and anti-inflammatory medications). The minimally invasive intervention 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 adjuvant, a Leucocyte-Rich PRP solution contrasted with iohexol was instilled intrasomatically at each vertebral level. This solution was extracted from 120 mL of the patient’s autologous blood and distributed evenly over the treated vertebrae. After the intervention, the patient is in home recovery, which is proceeding without complications. Dr. Ruiz-López’s team will continue to report on the patient’s progress, whose case is expected to be published in scientific journals in the future, 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 having trusted the team at Clínica Vertebra to perform this intervention, which is expected to help in the future to be able to treat other patients with similar pathologies. We will continue to learn, improve, and offer effective therapies to our patients.

• [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.
• [2] Unidad del dolor David Abejón. “Primer caso de radiofrecuencia ablativa del nervio basivertebra en España” (20 Julio 2024) https://davidabejon.com/radiofrecuencia-ablativa-del-nervio-basivertebra-en-espana/