Section 1 of 6
Select vertebrogenic pain
The indication is an imaging finding plus a clinical pattern.
Risks and benefits
Intended benefit
The intended outcome is less axial back pain and better function in vertebrogenic pain with Modic type 1 or 2 change. In the sham-controlled trial the per-protocol difference favoured ablation while the intent-to-treat difference was not significant; open-label and single-arm reports show larger improvements.
Risks and tradeoffs
Discuss transient radicular pain (the commonest complication, about 2 %), compression fracture, venous thromboembolism, and nerve-root injury from a medial pedicle breach. The 15-minute and 7-minute protocols have different evidence bases.
Make the decision together
Compare continued conservative care and treatment of competing facet, disc or sacroiliac sources. Explain which levels are treated and why, and what the evidence does and does not show, including its manufacturer funding.