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.

Objective　To examine whether urocortin is produced locally to regulate utero-placental vascular tone during pregnancy. Methods　We examined the distribution of urocortin in human placenta, fetal membranes and uterine tissue at term in the presence and absence of labor using a urocortin antibody produced in our laboratory and the immunoperoxidase staining method. Subsequently, we tested urocortin secretion from chorio-decidual cells in vitro using an immunoblot technique. Then， we tested whether urocortin is present in maternal plasma throughout gestation using a radioimmunoassay. A Sephadex G-50 column was used to examine whether immunoreactive urocortin (IR-urocortin) in maternal plasma is the same as synthetic urocortin. Results　IR-urocortin was observed in vascular smooth muscle of myometrium decidual stromal cells, syncytiotrophoblast and amnion epithelium. No differences in staining intensity for urocortin were detected between tissues obtained in the absence or presence of labor. Staining intensity for IR-urocortin was greatest in the decidua, suggesting this may be the main site of urocortin production. Positive staining for urocortin was observed in 40% of chorio-decidual cells with 34% of these cells secreting urocortin under basal conditions. Urocortin was detectable in maternal plasma from 16 weeks gestation and concentrations did not change as gestation progressed. IR-urocortin in the maternal plasma eluted from a Sephadex G-50 column at the same site as synthetic urocortin and had a calculated retention co-efficient of 0.44. Conclusion　This study indicates that urocortin is produced by the decidua during human pregnancy and is detectable in maternal plasma. These data are consistent with the hypothesis that urocortin is produced locally by the decidua and may act to regulate utero-placental blood flow.