Objective: This study presents an early multicentre experience with an adapted basivertebral nerve ablation (BVNA) technique using bilateral transpedicular access, evaluating its safety, efficacy, and potential for expanded indications. Methods: Participants were recruited from 2 Gold Coast centres based on the presence of chronic, sharp midline axial lower back pain and evidence of type 1 or type 2 Modic changes on imaging. The radiofrequency ablation procedure was performed via transpedicular access under computed tomographic guidance. Satisfaction outcomes were assessed at 2 months using a visual analogue scale and Likert scales. Statistical analyses compared outcomes according to sex and pain indications. Results: Forty patients were included in the study, of whom 33 underwent BVNA for Modic type 1 and type 2 vertebrogenic pain, and 8 underwent the procedure for expanded indications, with no complications reported. Among those treated for expanded indications, 2 had vertebrogenic endplate changes adjacent to a prior fusion, 2 had persistent pain following subacute osteoporotic fractures, and one each presented with a haemangioma, inflammatory endplate osteitis associated with spondyloarthropathy, and a postmyeloma fracture. Overall, 75% of participants reported being satisfied or very satisfied with the treatment of their painful condition. All patients treated for expanded indications expressed satisfaction or high satisfaction, with visual analogue score reductions ranging from 30% to 100%. Conclusion Early experience with BVNA using a bilateral transpedicular access technique suggests that it is a safe and effective procedure. It may also be applicable in selected cases involving expanded indications, particularly where persistent back pain remains refractory to or unsuitable for other therapeutic options.

Background: Chronic kidney disease (CKD) patients have poor cardiorespiratory fitness. Although cardiopulmonary exercise testing (CPET) is a universal assessment of cardiorespiratory fitness, values taken at ‘peak’ effort are strongly influenced by motivation and the choice of test endpoint. The oxygen uptake efficiency slope (OUES) integrates cardiovascular, musculoskeletal, and respiratory function into a single index to provide a more pragmatic and safer alternative to maximal testing. No research has explored whether exercise can improve the OUES in CKD patients. Methods: Thirty-two patients with non-dialysis CKD were recruited into a 12-week exercise program consisting of mixed aerobic and resistance training three times a week. CPET was conducted at baseline, and then, following a 6-week control period, at pre- and post-exercise intervention. Direct measurements of oxygen consumption (V̇O2) and ventilatory parameters were collected. The OUES was calculated as the relationship between V̇O2 and the log10 of minute ventilation (V̇E). Results: No changes were observed in any variable during the control period, although modest increases in V̇O2peak were observed. No meaningful changes were observed as a result of exercise in any cardiorespiratory value obtained. The OUES calculated at 100%, 90%, 75%, and 50% of exercise duration did not change significantly after 12 weeks of exercise training. Conclusion Our results show that 12 weeks of exercise training had no beneficial effects on the OUES, which supports the modest change observed in V̇O2peak. The lack of change in the OUES and other parameters could indicate a dysfunctional cardiorespiratory response to exercise in patients with CKD, likely mediated by dysfunctional peripheral metabolic mechanisms.