{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T19:17:01Z","timestamp":1777058221686,"version":"3.51.4"},"reference-count":35,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,3,25]]},"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:p>Lumbar radiculopathy due to impingement of nerve roots from facet hypertrophy and\/or disc herniation can often coincide with vertebrogenic low back pain. This is demonstrated on MRI with foraminal stenosis and Modic changes. We examine the potential of using a combination of basivertebral nerve ablation (BVNA) and lumbar laminotomy as an alternative to traditional spinal fusion in specific patient populations. This unique combination of surgical techniques has not been previously reported in the medical literature. We report a man in his late 30s with chronic low back pain and lumbar radiculopathy, treated with BVNA and concurrent laminotomy. The patient reported progressive improvements in his mobility and pain over the next 2 years. We discuss the advantages of using this technique for lumbar radiculopathy and Modic changes compared with conventional surgical modalities.<\/jats:p>","DOI":"10.1136\/bcr-2024-259695","type":"journal-article","created":{"date-parts":[[2024,4,4]],"date-time":"2024-04-04T13:40:19Z","timestamp":1712238019000},"page":"e259695","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Basivertebral nerve ablation with concurrent lumbar laminotomy"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5743-5123","authenticated-orcid":false,"given":"Jason L","family":"Marcus","sequence":"first","affiliation":[{"name":"Nova Southeastern University Dr Kiran C Patel College of Osteopathic Medicine, Clearwater, Florida, USA"},{"name":"Cantor Spince Center, Interventional Spine, Paley Orthopedic & Spine Institute, Fort Lauderdale, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin D","family":"Westerhaus","sequence":"additional","affiliation":[{"name":"Cantor Spince Center, Interventional Spine, Paley Orthopedic & Spine Institute, Fort Lauderdale, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brendan","family":"Chernicki","sequence":"additional","affiliation":[{"name":"Nova Southeastern University Dr Kiran C Patel College of Osteopathic Medicine, Clearwater, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Giuffrida","sequence":"additional","affiliation":[{"name":"Cantor Spince Center, Interventional Spine, Paley Orthopedic & Spine Institute, Fort Lauderdale, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,4,4]]},"reference":[{"key":"2025082703274967000_17.4.e259695.1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-008-0770-2"},{"key":"2025082703274967000_17.4.e259695.2","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1016\/j.jcot.2020.06.025","article-title":"Modic changes - an evidence-based, narrative review on its Patho-physiology, clinical significance and role in chronic low back pain","volume":"11","author":"Viswanathan","year":"2020","journal-title":"J Clin Orthop Trauma"},{"key":"2025082703274967000_17.4.e259695.3","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-008-0758-y"},{"key":"2025082703274967000_17.4.e259695.4","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-198803000-00015"},{"key":"2025082703274967000_17.4.e259695.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2007.01.008"},{"key":"2025082703274967000_17.4.e259695.6","doi-asserted-by":"publisher","DOI":"10.31616\/asj.2020.0472"},{"key":"2025082703274967000_17.4.e259695.7","doi-asserted-by":"crossref","DOI":"10.1007\/s11916-019-0757-1","article-title":"Low back pain, a comprehensive review: pathophysiology, diagnosis, and treatment","volume":"23","author":"Urits","year":"2019","journal-title":"Curr Pain Headache Rep"},{"key":"2025082703274967000_17.4.e259695.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2020.11.014"},{"key":"2025082703274967000_17.4.e259695.9","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1080\/02688697.2020.1777253","article-title":"Bilateral Laminotomy through a unilateral approach (minimally invasive) versus open laminectomy for lumbar spinal stenosis","volume":"35","author":"Horan","year":"2021","journal-title":"Br J Neurosurg"},{"key":"2025082703274967000_17.4.e259695.10","doi-asserted-by":"crossref","DOI":"10.1186\/s12891-020-03820-2","article-title":"Comparison of lumbar endoscopic unilateral Laminotomy bilateral decompression and minimally invasive surgery Transforaminal lumbar Interbody fusion for one-level lumbar spinal stenosis","volume":"21","author":"Hua","year":"2020","journal-title":"BMC Musculoskelet Disord"},{"key":"2025082703274967000_17.4.e259695.11","doi-asserted-by":"crossref","first-page":"e361","DOI":"10.1016\/j.wneu.2021.03.018","article-title":"Lumbar endoscopic unilateral Laminotomy for bilateral decompression for lumbar spinal stenosis provides comparable clinical outcomes in patients with and without degenerative Spondylolisthesis","volume":"150","author":"Yoshikane","year":"2021","journal-title":"World Neurosurgery"},{"key":"2025082703274967000_17.4.e259695.12","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-020-06448-x"},{"key":"2025082703274967000_17.4.e259695.13","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-018-5496-1"},{"key":"2025082703274967000_17.4.e259695.14","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200011150-00017"},{"key":"2025082703274967000_17.4.e259695.15","doi-asserted-by":"crossref","first-page":"2393","DOI":"10.1097\/00007632-199710150-00014","article-title":"Regional variation in vertebral bone density and trabecular architecture are influenced by Osteoarthritic change and osteoporosis","volume":"22","author":"Antonacci","year":"1997","journal-title":"Spine (Phila Pa 1976)"},{"key":"2025082703274967000_17.4.e259695.16","doi-asserted-by":"crossref","first-page":"2700","DOI":"10.1097\/01.brs.0000146499.97948.52","article-title":"Nutrition of the Intervertebral disc","volume":"29","author":"Urban","year":"2004","journal-title":"Spine (Phila Pa 1976)"},{"key":"2025082703274967000_17.4.e259695.17","doi-asserted-by":"publisher","DOI":"10.3109\/03008208109152130"},{"key":"2025082703274967000_17.4.e259695.18","doi-asserted-by":"crossref","unstructured":"Ogata K , Whiteside LA . Nutritional pathways of the Intervertebral disc. An experimental study using hydrogen Washout technique. Spine (Phila Pa 1976) 1981;211\u20136.","DOI":"10.1097\/00007632-198105000-00003"},{"key":"2025082703274967000_17.4.e259695.19","doi-asserted-by":"publisher","DOI":"10.1002\/path.1108"},{"key":"2025082703274967000_17.4.e259695.20","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.79B1.6814"},{"key":"2025082703274967000_17.4.e259695.21","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-015-4037-4"},{"key":"2025082703274967000_17.4.e259695.22","unstructured":"Tieppo Francio V , Sayed D . Basivertebral nerve ablation. In: StatPearls. StatPearls Publishing, 2022."},{"key":"2025082703274967000_17.4.e259695.23","doi-asserted-by":"crossref","DOI":"10.1186\/s13018-020-01605-w","article-title":"Vertebral Intraosseous plasma rich in growth factor (PRGF-Endoret) Infiltrations as a novel strategy for the treatment of degenerative lesions of Endplate in lumbar pathology: description of technique and case presentation","volume":"15","author":"Kirchner","year":"2020","journal-title":"J Orthop Surg Res"},{"key":"2025082703274967000_17.4.e259695.24","doi-asserted-by":"crossref","unstructured":"Kim HS , Adsul N , Yudoyono F , et al . Transforaminal Epiduroscopic basivertebral nerve laser ablation for chronic low back pain associated with modic changes: a preliminary open-label study. Pain Res Manag 2018;2018. doi:10.1155\/2018\/6857983","DOI":"10.1155\/2018\/6857983"},{"key":"2025082703274967000_17.4.e259695.25","doi-asserted-by":"crossref","first-page":"21","DOI":"10.2152\/jmi.67.21","article-title":"The role of propionibacterium acnes in and Modic type 1 changes: a literature review","volume":"67","author":"Jha","year":"2020","journal-title":"J Med Invest"},{"key":"2025082703274967000_17.4.e259695.26","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1002\/jor.23265","article-title":"Propionibacterium Acnes infected Intervertebral discs cause vertebral bone marrow lesions consistent with Modic changes","volume":"34","author":"Dudli","year":"2016","journal-title":"J Orthop Res"},{"key":"2025082703274967000_17.4.e259695.27","doi-asserted-by":"crossref","DOI":"10.1186\/s13063-021-05728-1","article-title":"Is antibiotic treatment effective in the management of chronic low back pain with disc Herniation? study protocol for a randomised controlled trial","volume":"22","author":"Urquhart","year":"2021","journal-title":"Trials"},{"key":"2025082703274967000_17.4.e259695.28","doi-asserted-by":"crossref","first-page":"1876","DOI":"10.1007\/s00586-023-07694-5","article-title":"Biomechanics after spinal decompression and posterior instrumentation","volume":"32","author":"Burkhard","year":"2023","journal-title":"Eur Spine J"},{"key":"2025082703274967000_17.4.e259695.29","doi-asserted-by":"crossref","first-page":"143S","DOI":"10.1097\/00007632-199512151-00012","article-title":"The indications for lumbar spinal fusion with and without instrumentation","volume":"20","author":"Hanley","year":"1995","journal-title":"Spine (Phila PA 1976)"},{"key":"2025082703274967000_17.4.e259695.30","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.wneu.2022.04.087","article-title":"Transforaminal endoscopic decompression for foraminal stenosis: single-arm meta-analysis and systematic review","volume":"168","author":"Liu","year":"2022","journal-title":"World Neurosurg"},{"key":"2025082703274967000_17.4.e259695.31","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2474-9-84","article-title":"Biomechanical comparison of lumbar spine instability between Laminectomy and bilateral Laminotomy for spinal stenosis syndrome \u2013 an experimental study in porcine model","volume":"9","author":"Tai","year":"2008","journal-title":"BMC Musculoskelet Disord"},{"key":"2025082703274967000_17.4.e259695.32","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1097\/BRS.0b013e318273a2ea","article-title":"Prevalence of adjacent segment degeneration after spine surgery: a systematic review and meta-analysis","volume":"38","author":"Xia","year":"2013","journal-title":"Spine (Phila Pa 1976)"},{"key":"2025082703274967000_17.4.e259695.33","doi-asserted-by":"crossref","DOI":"10.1186\/s13018-019-1150-9","article-title":"Biomechanical study of proximal adjacent segment degeneration after posterior lumbar Interbody fusion and fixation: a finite element analysis","volume":"14","author":"Jiang","year":"2019","journal-title":"J Orthop Surg Res"},{"key":"2025082703274967000_17.4.e259695.34","doi-asserted-by":"publisher","DOI":"10.1302\/2058-5241.6.210050"},{"key":"2025082703274967000_17.4.e259695.35","doi-asserted-by":"crossref","first-page":"354","DOI":"10.21037\/jss-21-26","article-title":"A descriptive study on the adjacent segment degeneration related signs following a lumbar fusion procedure","volume":"7","author":"Ram\u00edrez-Villaescusa","year":"2021","journal-title":"J Spine Surg"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-259695","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T10:28:00Z","timestamp":1756290480000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-259695"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4]]},"references-count":35,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4,4]]},"published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1136\/bcr-2024-259695"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-259695","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4]]}}}