{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T23:31:40Z","timestamp":1769729500870,"version":"3.49.0"},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"21","license":[{"start":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T00:00:00Z","timestamp":1731888000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2024,11,18]]},"abstract":"\n BACKGROUND<\/jats:title>\n Avascular necrosis (AVN) of the spine is a rare sequela of chronic sickle cell disease (SCD) in which the shape of the sickled red blood cells interfere with the normal vascular supply of vertebral bodies. In this report, the authors describe a case of progressive spinal AVN treated with radiofrequency ablation (RFA) and kyphoplasty for the patient\u2019s persistent lower back pain.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n A 38-year-old male with long-standing spinal AVN due to SCD had been managed conservatively with hydroxyurea and oral opioid analgesics for several years until breakthrough episodes of low-back pain began to occur with an inability to perform activities of daily life. The patient\u2019s condition progressed to involve multiple vertebral bodies, leading to a refractory response. Bipedicular RFA directed at L3 and L4 with kyphoplasty was proposed as a novel, minimally invasive approach. The patient was found to have lasting postoperative relief.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n Patients with pain attributed to a sickle cell crisis can benefit from RFA and kyphoplasty to potentially eliminate or minimize symptoms from spinal AVN due to chronic SCD not responding to conservative management.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE24343<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case24343","type":"journal-article","created":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T01:44:55Z","timestamp":1731894295000},"source":"Crossref","is-referenced-by-count":2,"title":["Minimally invasive treatment with radiofrequency ablation and kyphoplasty for avascular necrosis of the spine in sickle cell disease: illustrative case"],"prefix":"10.3171","volume":"8","author":[{"given":"Rahul","family":"Mehta","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manisha","family":"Koneru","sequence":"additional","affiliation":[{"name":"Departments of Neurointerventional Surgery, Cooper University Health Care, Camden, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clint","family":"Badger","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, Cooper University Health Care, Camden, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua","family":"Santucci","sequence":"additional","affiliation":[{"name":"Departments of Neurointerventional Surgery, Cooper University Health Care, Camden, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zein","family":"Al-Atrache","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, Cooper University Health Care, Camden, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina M.","family":"Clay","sequence":"additional","affiliation":[{"name":"Departments of Hematology\/Medical Oncology, Cooper University Health Care, Camden, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven S.","family":"Yocom","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, Cooper University Health Care, Camden, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamza A.","family":"Shaikh","sequence":"additional","affiliation":[{"name":"Departments of Neurointerventional Surgery, Cooper University Health Care, Camden, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"bib1","series-title":"Hematologia","first-page":"2085","article-title":"PB2215: global epidemiology of sickle cell disease: a systematic literature review","volume":"6","author":"Colombatti","year":"2022","unstructured":"Colombatti RBirkeg\u00e5rd CMedici M. PB2215: global epidemiology of sickle cell disease: a systematic literature review. Hematologia. 2022;6:2085-2086."},{"issue":"38","key":"bib2","series-title":"Medicine","first-page":"e35237","article-title":"Understanding sickle cell disease: causes, symptoms, and treatment options","volume":"102","author":"Elendu","year":"2023","unstructured":"Elendu CAmaechi DCAlakwe-Ojimba CE, et al. Understanding sickle cell disease: causes, symptoms, and treatment options. Medicine. 2023;102(38):e35237."},{"issue":"7","key":"bib3","series-title":"Glob Spine J","first-page":"761","article-title":"Review of sickle cell disease and spinal pathology","volume":"9","author":"Rudy","year":"2019","unstructured":"Rudy HLYang DNam ADCho W. Review of sickle cell disease and spinal pathology. Glob Spine J. 2019;9(7):761-766."},{"issue":"11","key":"bib4","series-title":"Blood","first-page":"3782","article-title":"A randomized controlled trial of patient controlled analgesia versus continuous infusion of morphine during vaso-occlusive crisis in sickle cell disease","volume":"106","author":"Van Beers","year":"2005","unstructured":"Van Beers EJNieuwkerk PTVan Tuijn CFJFriederich PWVranken JHBiemond BJ. A randomized controlled trial of patient controlled analgesia versus continuous infusion of morphine during vaso-occlusive crisis in sickle cell disease. Blood. 2005;106(11):3782."},{"key":"bib5","series-title":"StatPearls","article-title":"Patient-controlled analgesia","author":"Pastino","year":"2024","unstructured":"Pastino ALakra A. Patient-controlled analgesia. In: StatPearls. StatPearls Publishing. 2024. Accessed July 14, 2024. http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK551610\/"},{"issue":"4","key":"bib6","series-title":"HCA Healthc J Med","first-page":"303","article-title":"Utilization of patient-controlled analgesia reduces length of stay of sickle cell crisis hospitalizations","volume":"2","author":"Prestia","year":"2021","unstructured":"Prestia BMRamzan TWaldron C, et al. Utilization of patient-controlled analgesia reduces length of stay of sickle cell crisis hospitalizations. HCA Healthc J Med. 2021;2(4):303-309."},{"issue":"2","key":"bib7","series-title":"Clin Trials","first-page":"319","article-title":"IMPROVE trial: A randomized controlled trial of patient-controlled analgesia for sickle cell painful episodes: rationale, design challenges, initial experience, and recommendations for future studies","volume":"10","author":"Dampier","year":"2013","unstructured":"Dampier CDSmith WRWager CG, et al. IMPROVE trial: A randomized controlled trial of patient-controlled analgesia for sickle cell painful episodes: rationale, design challenges, initial experience, and recommendations for future studies. Clin Trials. 2013;10(2):319-331."},{"issue":"6","key":"bib8","series-title":"N Engl J Med","first-page":"509","article-title":"A Phase 3 randomized trial of voxelotor in sickle cell disease","volume":"381","author":"Vichinsky","year":"2019","unstructured":"Vichinsky EHoppe CCAtaga KI, et al. A Phase 3 randomized trial of voxelotor in sickle cell disease. N Engl J Med. 2019;381(6):509-519."},{"key":"bib9","series-title":"Front Med (Lausanne)","first-page":"1063255","article-title":"Complete resolution of stage II avascular necrosis affecting three joints by hyperbaric oxygen in a patient with sickle cell disease: a case report","volume":"9","author":"Alshurafa","year":"2022","unstructured":"Alshurafa AElhissi MYassin MA. Complete resolution of stage II avascular necrosis affecting three joints by hyperbaric oxygen in a patient with sickle cell disease: a case report. Front Med (Lausanne). 2022;9:1063255."},{"issue":"suppl","key":"bib10","series-title":"Indian J Hematol Blood Transfus","first-page":"124","article-title":"Multiple vertebral necrosis in a sickle cell trait: a rare manifestations","volume":"30","author":"Taksande","year":"2014","unstructured":"Taksande BAKotpalliwar SSabarwal SPatil M. Multiple vertebral necrosis in a sickle cell trait: a rare manifestations. Indian J Hematol Blood Transfus. 2014;30(suppl 1):124-125."},{"issue":"5","key":"bib11","series-title":"Pain Res Manag","first-page":"e146","article-title":"Radiofrequency ablation for chronic low back pain: a systematic review of randomized controlled trials","volume":"19","author":"Leggett","year":"2014","unstructured":"Leggett LESoril LJJLorenzetti DL, et al. Radiofrequency ablation for chronic low back pain: a systematic review of randomized controlled trials. Pain Res Manag. 2014;19(5):e146-e153."},{"key":"bib12","series-title":"StatPearls","article-title":"Radiofrequency ablation","author":"Wray","year":"2024","unstructured":"Wray JKDixon BPrzkora R. Radiofrequency ablation. In: StatPearls. StatPearls Publishing. 2024. Accessed July 14, 2024. http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK482387\/"},{"issue":"1","key":"bib13","series-title":"Spine J","first-page":"63","article-title":"Substance P\u2013containing nerves within the human vertebral body. an immunohistochemical study of the basivertebral nerve","volume":"3","author":"Fras","year":"2003","unstructured":"Fras CKravetz PMody DRHeggeness MH. Substance P\u2013containing nerves within the human vertebral body. an immunohistochemical study of the basivertebral nerve. 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BMC Musculoskelet Disord. 2021;22(1):912."},{"issue":"1","key":"bib16","series-title":"World J Surg Oncol","first-page":"90","article-title":"Treatment of pathologic spinal fractures with combined radiofrequency ablation and balloon kyphoplasty","volume":"7","author":"Katonis","year":"2009","unstructured":"Katonis PPasku DAlpantaki KBano ATzanakakis GKarantanas A. Treatment of pathologic spinal fractures with combined radiofrequency ablation and balloon kyphoplasty. World J Surg Oncol. 2009;7(1):90."},{"issue":"2","key":"bib17","series-title":"Am J Hematol","first-page":"103","article-title":"Core decompression in avascular necrosis of the hip in sickle-cell disease","volume":"52","author":"Styles","year":"1996","unstructured":"Styles LAVichinsky EP. Core decompression in avascular necrosis of the hip in sickle-cell disease. Am J Hematol. 1996;52(2):103-107."},{"issue":"3","key":"bib18","series-title":"Asian Spine J","first-page":"586","article-title":"What is the current evidence on vertebral body osteonecrosis?: a systematic review of the literature","volume":"12","author":"Formica","year":"2018","unstructured":"Formica MZanirato ACavagnaro L, et al. What is the current evidence on vertebral body osteonecrosis?: a systematic review of the literature. Asian Spine J. 2018;12(3):586-599."},{"issue":"4","key":"bib19","series-title":"Spine","first-page":"E158","article-title":"Avascular necrosis of the spine in solid posterior fusion segments","volume":"34","author":"Lee","year":"2009","unstructured":"Lee JHKim KTSuk KSLee SHJeong BO. Avascular necrosis of the spine in solid posterior fusion segments. Spine. 2009;34(4):E158-E161."},{"key":"bib1","series-title":"Hematologia","first-page":"2085","article-title":"PB2215: global epidemiology of sickle cell disease: a systematic literature review","volume":"6","author":"Colombatti","year":"2022","unstructured":"Colombatti RBirkeg\u00e5rd CMedici M. PB2215: global epidemiology of sickle cell disease: a systematic literature review. Hematologia. 2022;6:2085-2086."},{"issue":"38","key":"bib2","series-title":"Medicine","first-page":"e35237","article-title":"Understanding sickle cell disease: causes, symptoms, and treatment options","volume":"102","author":"Elendu","year":"2023","unstructured":"Elendu CAmaechi DCAlakwe-Ojimba CE, et al. Understanding sickle cell disease: causes, symptoms, and treatment options. Medicine. 2023;102(38):e35237."},{"issue":"7","key":"bib3","series-title":"Glob Spine J","first-page":"761","article-title":"Review of sickle cell disease and spinal pathology","volume":"9","author":"Rudy","year":"2019","unstructured":"Rudy HLYang DNam ADCho W. Review of sickle cell disease and spinal pathology. Glob Spine J. 2019;9(7):761-766."},{"issue":"11","key":"bib4","series-title":"Blood","first-page":"3782","article-title":"A randomized controlled trial of patient controlled analgesia versus continuous infusion of morphine during vaso-occlusive crisis in sickle cell disease","volume":"106","author":"Van Beers","year":"2005","unstructured":"Van Beers EJNieuwkerk PTVan Tuijn CFJFriederich PWVranken JHBiemond BJ. A randomized controlled trial of patient controlled analgesia versus continuous infusion of morphine during vaso-occlusive crisis in sickle cell disease. Blood. 2005;106(11):3782."},{"key":"bib5","series-title":"StatPearls","article-title":"Patient-controlled analgesia","author":"Pastino","year":"2024","unstructured":"Pastino ALakra A. Patient-controlled analgesia. In: StatPearls. StatPearls Publishing. 2024. Accessed July 14, 2024. http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK551610\/"},{"issue":"4","key":"bib6","series-title":"HCA Healthc J Med","first-page":"303","article-title":"Utilization of patient-controlled analgesia reduces length of stay of sickle cell crisis hospitalizations","volume":"2","author":"Prestia","year":"2021","unstructured":"Prestia BMRamzan TWaldron C, et al. Utilization of patient-controlled analgesia reduces length of stay of sickle cell crisis hospitalizations. HCA Healthc J Med. 2021;2(4):303-309."},{"issue":"2","key":"bib7","series-title":"Clin Trials","first-page":"319","article-title":"IMPROVE trial: A randomized controlled trial of patient-controlled analgesia for sickle cell painful episodes: rationale, design challenges, initial experience, and recommendations for future studies","volume":"10","author":"Dampier","year":"2013","unstructured":"Dampier CDSmith WRWager CG, et al. IMPROVE trial: A randomized controlled trial of patient-controlled analgesia for sickle cell painful episodes: rationale, design challenges, initial experience, and recommendations for future studies. Clin Trials. 2013;10(2):319-331."},{"issue":"6","key":"bib8","series-title":"N Engl J Med","first-page":"509","article-title":"A Phase 3 randomized trial of voxelotor in sickle cell disease","volume":"381","author":"Vichinsky","year":"2019","unstructured":"Vichinsky EHoppe CCAtaga KI, et al. A Phase 3 randomized trial of voxelotor in sickle cell disease. N Engl J Med. 2019;381(6):509-519."},{"key":"bib9","series-title":"Front Med (Lausanne)","first-page":"1063255","article-title":"Complete resolution of stage II avascular necrosis affecting three joints by hyperbaric oxygen in a patient with sickle cell disease: a case report","volume":"9","author":"Alshurafa","year":"2022","unstructured":"Alshurafa AElhissi MYassin MA. Complete resolution of stage II avascular necrosis affecting three joints by hyperbaric oxygen in a patient with sickle cell disease: a case report. Front Med (Lausanne). 2022;9:1063255."},{"issue":"suppl","key":"bib10","series-title":"Indian J Hematol Blood Transfus","first-page":"124","article-title":"Multiple vertebral necrosis in a sickle cell trait: a rare manifestations","volume":"30","author":"Taksande","year":"2014","unstructured":"Taksande BAKotpalliwar SSabarwal SPatil M. Multiple vertebral necrosis in a sickle cell trait: a rare manifestations. Indian J Hematol Blood Transfus. 2014;30(suppl 1):124-125."},{"issue":"5","key":"bib11","series-title":"Pain Res Manag","first-page":"e146","article-title":"Radiofrequency ablation for chronic low back pain: a systematic review of randomized controlled trials","volume":"19","author":"Leggett","year":"2014","unstructured":"Leggett LESoril LJJLorenzetti DL, et al. Radiofrequency ablation for chronic low back pain: a systematic review of randomized controlled trials. Pain Res Manag. 2014;19(5):e146-e153."},{"key":"bib12","series-title":"StatPearls","article-title":"Radiofrequency ablation","author":"Wray","year":"2024","unstructured":"Wray JKDixon BPrzkora R. Radiofrequency ablation. In: StatPearls. StatPearls Publishing. 2024. Accessed July 14, 2024. http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK482387\/"},{"issue":"1","key":"bib13","series-title":"Spine J","first-page":"63","article-title":"Substance P\u2013containing nerves within the human vertebral body. an immunohistochemical study of the basivertebral nerve","volume":"3","author":"Fras","year":"2003","unstructured":"Fras CKravetz PMody DRHeggeness MH. Substance P\u2013containing nerves within the human vertebral body. an immunohistochemical study of the basivertebral nerve. Spine J. 2003;3(1):63-67."},{"key":"bib14","series-title":"J Pain Res","first-page":"1887","article-title":"Developments in minimally invasive surgical options for vertebral pain: basivertebral nerve ablation\u2013a narrative review","volume":"14","author":"Tieppo Francio","year":"2021","unstructured":"Tieppo Francio VSherwood DTwohey E, et al. Developments in minimally invasive surgical options for vertebral pain: basivertebral nerve ablation\u2013a narrative review. J Pain Res. 2021;14:1887-1907."},{"issue":"1","key":"bib15","series-title":"BMC Musculoskelet Disord","first-page":"912","article-title":"Role of radiofrequency ablation and cement injection for pain control in patients with spinal metastasis","volume":"22","author":"Yildizhan","year":"2021","unstructured":"Yildizhan SBoyaci MGRakip UAslan ACanbek I. Role of radiofrequency ablation and cement injection for pain control in patients with spinal metastasis. BMC Musculoskelet Disord. 2021;22(1):912."},{"issue":"1","key":"bib16","series-title":"World J Surg Oncol","first-page":"90","article-title":"Treatment of pathologic spinal fractures with combined radiofrequency ablation and balloon kyphoplasty","volume":"7","author":"Katonis","year":"2009","unstructured":"Katonis PPasku DAlpantaki KBano ATzanakakis GKarantanas A. Treatment of pathologic spinal fractures with combined radiofrequency ablation and balloon kyphoplasty. World J Surg Oncol. 2009;7(1):90."},{"issue":"2","key":"bib17","series-title":"Am J Hematol","first-page":"103","article-title":"Core decompression in avascular necrosis of the hip in sickle-cell disease","volume":"52","author":"Styles","year":"1996","unstructured":"Styles LAVichinsky EP. Core decompression in avascular necrosis of the hip in sickle-cell disease. Am J Hematol. 1996;52(2):103-107."},{"issue":"3","key":"bib18","series-title":"Asian Spine J","first-page":"586","article-title":"What is the current evidence on vertebral body osteonecrosis?: a systematic review of the literature","volume":"12","author":"Formica","year":"2018","unstructured":"Formica MZanirato ACavagnaro L, et al. What is the current evidence on vertebral body osteonecrosis?: a systematic review of the literature. 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