Concurrent basivertebral nerve radiofrequency ablation and vertebral augmentation as part of a multimodal palliative plan for pathological vertebral compression fracture from spine tumor: A case series of three patients

Introduction Pathological vertebral compression fractures from spinal tumors are a source of severe back pain and functional disability. Vertebral augmentation (VA) has been utilized for mechanical stabilization; however, pain may persist due to nociceptive signaling from the basivertebral nerve (BVN). BVN radiofrequency ablation (BVNRFA) has shown efficacy for vertebrogenic back pain associated with Modic changes, but its efficacy for oncologic/pathologic fractures remains an area of exploration. Case presentation We present a case series of three patients with pathological vertebral compression fractures secondary to spinal tumors who underwent concurrent BVNRFA and VA. All three patients experienced immediate and sustained pain reduction with improvements in function. No peri- or post-procedural complications were observed at one-month follow-up. Conclusion Concurrent BVNRFA and VA is a novel and synergistic approach that may provide an additional option for select patients with pathological vertebral compression fractures from a spinal tumor within palliative and interventional pain settings. Larger studies are required to clarify ideal patient selection, duration of benefit, and safety.