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: Transforming growth factor beta (TGF-β) signaling has been shown to control a large number of critical cellular actions such as cell death, differentiation, and development and has been implicated as a major regulator of placental function. SM10 cells are a mouse placental progenitor cell line, which has been previously shown to differentiate into nutrient transporting, labyrinthine-like cells upon treatment with TGF-β. However, the signal transduction pathway activated by TGF-β to induce SM10 progenitor differentiation has yet to be fully investigated. MATERIALS AND METHODS: In this study the SM10 labyrinthine progenitor cell line was used to investigate TGF-β induced differentiation. Activation of the TGF-β pathway and the ability of TGF-β to induce differentiation were investigated by light microscopy, luciferase assays, and Western blot analysis. RESULTS AND CONCLUSIONS: In this report, we show that three isoforms of TGF-β have the ability to terminally differentiate SM10 cells, whereas other predominant members of the TGF-β superfamily, Nodal and Activin A, do not. Additionally, we have determined that TGF-β induced Smad2 phosphorylation can be mediated via the ALK-5 receptor with subsequent transactivation of the Activin response element. Our studies identify an important regulatory signaling pathway in SM10 progenitor cells that is involved in labyrinthine trophoblast differentiation.
Activins ; Animals ; Blotting, Western ; Cell Death ; Luciferases ; Mice ; Microscopy ; Phosphorylation ; Placenta ; Protein Isoforms ; Response Elements ; Signal Transduction ; Stem Cells ; Transcriptional Activation ; Transforming Growth Factor beta ; Trophoblasts

No abstract available.
Upper Extremity*