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. 2023 Aug 3;2(3):100270.
doi: 10.1016/j.inpm.2023.100270. eCollection 2023 Sep.

Radicular pain following low lumbar basivertebral nerve ablation

Jacob Benrud  1 , Yakov Vorobeychik  1
Affiliations

Radicular pain following low lumbar basivertebral nerve ablation

Jacob Benrud et al. Interv Pain Med. .
No abstract available

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
(A, B) Axial cut of L1 (A) and L3 (B) on MRI illustrating the concave or kidney shape of the vertebral body (white line). Blue line represents a topical path of the introducer through the pedicle. Green curved line represents the approximate path of the curved stylet that is usually introduced just as the posterior wall of the vertebral body is reached on a lateral fluoroscopic image. Lines C and D represent the posterior wall of the vertebral body as would be seen in a lateral fluoroscopic image. BVNA is approved for L3 to S1 vertebral levels. We included an L1 image to show a gradual transition of the lumbar vertebral body shape from concave at the upper lumbar levels to oval at the L5 level. Furthermore, the current approval may be expanded at a future date to include vertebral levels cephalad from L3. (C) Axial cut of L5 on MRI illustrating the convex shape of the L5 vertebral body (white line). Red line represents an approximal path of an introducer with curved green line representing the path of curved stylet. Note that in this illustration the curved stylet comes dangerously close to the L5 spinal nerve root and potentially can breach the pedicle. The blue line represents a safer path for an introducer accounting for the convex shape of the L5 vertebral body. Line A represents the posterior wall of the vertebral body whereas line B represents the anterior border of the pedicle. Introduction of the curved stylet at this more ventral location prevents breaching the pedicle and damaging the passing nerve. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
Fig. 2
Fig. 2
The lateral view radiograph illustrates where lines A, B, C, and D would appear on this image. Note that line A seems to be a safe location to begin introducing the curved stylet; however, if a curved stylet is introduced here, it will likely encounter, or be very close to, the spinal nerve root. Line B is more ventral and should be the point at which the curved stylet is introduced. The discrepancy between lines A and B is due to the convex shape of the L5 vertebral body. Lines C and D represent the posterior wall of the L1 and L3 vertebral bodies respectively.
See this image and copyright information in PMC

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