About

Dr. Aaron Conger is an Assistant Professor and Interventional Spine and Musculoskeletal Medicine specialist at the University of Utah's Department of Physical Medicine and Rehabilitation. He earned his Doctor of Osteopathic Medicine degree from Pacific Northwest University of Health Sciences in Washington State. He completed his residency in Physical Medicine and Rehabilitation, followed by a fellowship in Interventional Spine and Musculoskeletal Medicine at the University of Utah in Salt Lake City, Utah. His clinical expertise encompasses the treatment of spine and musculoskeletal pain conditions including osteoporotic compression fractures, arthritis of the spine, disc herniation, spinal stenosis, zygapophyseal joint pain, vertebrogenic pain, sacroiliac joint pain, and other degenerative conditions of the cervical, thoracic, and lumbar spine. Dr. Conger offers advanced pain management therapies such as Kyphoplasty, Spinal Cord Stimulation, Peripheral Nerve Stimulation, and Basivertebral Nerve Ablation (Intracept). He collaborates closely with orthopedic and neurosurgical spine specialists, as well as physical therapists, to deliver comprehensive care. Additionally, Dr. Conger is involved with the design and conduct of multiple clinical trials aimed at enhancing interventional treatments for patients with spine and musculoskeletal pain. He chairs the International Pain and Spine Intervention Society's Evidence Analysis Committee and serves on the editorial boards of the journals Pain Medicine and Interventional Pain Medicine. Dr. Conger has authored over 100 peer-reviewed abstracts and journal articles and directs the NASS Interventional Spine and Musculoskeletal Medicine Fellowship at the University of Utah.

Research topics

• Internal medicine
• Medicine
• Surgery
• Physical therapy
• Pathology
• Physical medicine and rehabilitation
• Intensive care medicine
• Family medicine
• Nursing
• Anesthesia
• Psychiatry
• Emergency medicine

Selected publications

• Evaluating prognostic block selection criteria in lumbar medical branch radiofrequency neurotomy: A retrospective cohort study

  Interventional Pain Medicine · 2026-02-25

  articleOpen access

  Patient selection for lumbar medial branch radiofrequency neurotomy (LMBRFN) remains a topic of debate. Different block paradigms may influence LMBRFN outcomes. This study examined the relationships between block paradigms and treatment results following LMBRFN. A retrospective cohort study of consecutive patients undergoing first-time LMBRFN between 2016 and 2022 at two associated Canadian clinics was performed. Patients were grouped into six prognostic block paradigms based on block type (medial branch block [MBB] vs. intra-articular block [IAB]), number of blocks (single vs. dual), and percent pain relief (50–79% vs. ≥80%): 1 = MBB/MBB ≥80%, 2 = MBB/MBB 50–79%, 3 = IAB/MBB ≥80%, 4 = IAB/MBB 50–79%, 5 = MBB ≥80%, and 6 = MBB 50–79%. Treatment success was defined by (1) ≥50% reduction in numerical rating scale (NRS) pain score and (2) the minimal clinically important difference (MCID) in Pain Disability Quality-of-Life Questionnaire–Spine (PDQQ-S) at 3 months post-procedure. Logistic regression was used to assess associations between block paradigm and outcomes while controlling for select demographic and clinical factors. Among 631 included patients (57.1% female; mean age 62.3 ± 12.9 years), 46.9% achieved ≥50% NRS reduction and 47.7% met the MCID for PDQQ-S at 3 months. No significant associations were found between block paradigms and ≥50% pain relief. However, the IAB/MBB 50–79% paradigm was associated with significantly lower odds of functional improvement by the PDQQ-S (OR = 0.31; p = 0.02). Patients who were working at the time of the procedure had higher odds of treatment success with respect to pain (OR = 2.51; p < 0.01) and function (OR = 2.21; p < 0.01). In this cohort, nearly half of patients experienced clinically meaningful pain reduction at 3 months post-LMBRFN, regardless of block selection criteria, challenging the need for restrictive paradigms. However, patients selected by IAB/MBB with 50–79% pain relief were less likely to experience clinically significant improvements to function. Active employment was linked to better 3-month outcomes for both pain and function, highlighting potential psychosocial factors. Larger prospective studies with long-term follow-up are needed to confirm these findings and optimize patient selection for LMBRFN.

  PublisherDOI

• The safety and effectiveness of lumbar transforaminal injection of sterile amniotic fluid filtrate compared to steroid for lumbosacral radicular pain due to spinal stenosis: a phase I/II double-blinded randomized trial

  Pain Medicine · 2026-03-27

  articleOpen access

  BACKGROUND: Radicular symptoms from lumbosacral spinal stenosis (LSS) are commonly managed with conservative measures, including transforaminal epidural steroid injection (TFESI). However, repeated use may cause systemic side effects in some patients. Human amniotic fluid filtrate (hAF), containing anti-inflammatory, neuroprotective, and regenerative factors, has shown therapeutic potential in pre-clinical models and other medical conditions. OBJECTIVES: Compare the safety and effectiveness of transforaminal epidural injections with hAF versus dexamethasone for treating radicular pain from LSS. DESIGN: Double-blinded, prospective, randomized comparative trial. METHODS: Fifty-eight participants were included, with outcomes assessed at 3 weeks, 6 weeks, 3 months (primary endpoint), and 6 months. Primary outcomes were adverse events (AEs) and proportions of participants reporting ≥50% numerical pain rating scale (NPRS) back and leg pain reductions at 3 months. Secondary outcomes included Oswestry Disability Index (ODI), Swiss Spinal Stenosis Questionnaire (SSSQ), and PROMIS Physical Health Summary (PHS). Linear mixed-effects models evaluated between-group differences while accounting for repeated measures. RESULTS: At 3 months, a significantly greater proportion of participants receiving dexamethasone achieved ≥50% reductions in back pain (45.8% [95%CI = 27.9-64.9%] vs. 15.0% [95%CI = 5.2-36.0%]; p = 0.050) and leg pain (60.0% [95%CI = 40.7-76.6%] vs. 25.0% [95%CI = 11.2-46.9%]; p = 0.034) compared with hAF. Secondary outcome trends similarly favored dexamethasone at 3 months. Mixed-effects models showed greater improvements to 6-week pain and function scores with dexamethasone relative to hAF. Group AE rates were comparable, and no serious intervention-related AEs occurred. CONCLUSION: Dexamethasone demonstrated significantly greater short- and intermediate-term benefits over hAF across multiple clinical outcome domains for radicular pain due to LSS, prompting early trial discontinuation.

  PublisherDOI

• Improving the contextual use of GRADE (Grading of Recommendations Assessment, Development, and Evaluation) for interventional pain procedures: bridging evidence certainty and clinical reality

  Pain Medicine · 2026-04-07

  article
  PublisherDOI

• Mechanical augmentation for vertebral compression fractures: A scoping review

  Interventional Pain Medicine · 2026-04-19

  articleOpen accessSenior author

  Background: Vertebral compression fractures (VCFs) contribute substantially to pain, disability, and healthcare burden. Vertebroplasty and balloon kyphoplasty (KP) are widely used but limited by cement leakage and inconsistent vertebral height restoration. Mechanical vertebral augmentation (MVA) techniques were developed to improve vertebral alignment and cement containment, yet their comparative outcomes remain incompletely defined. Objectives: To map and synthesize the existing evidence on MVA compared with KP or vertebroplasty across seven clinically relevant domains, including cement extravasation, alignment correction, pain and disability outcomes, morbidity and mortality, and feasibility in complex fracture patterns. Methods: A comprehensive search of MEDLINE, Embase, and Web of Science identified studies evaluating MVA in adult VCFs. Data were charted according to seven predefined research questions and synthesized descriptively using scoping-review methodology. Forest plots were used to visualize the ranges and distributions of reported outcomes across studies. Results: Fifty-two studies met inclusion criteria. Across studies, MVA demonstrated a trend toward lower cement extravasation rates compared with KP, although definitions and detection methods varied and intradiscal leakage was generally reported as asymptomatic. Vertebral height restoration and alignment correction were often greater or more consistently achieved with MVA devices, but the clinical relevance of these differences remains uncertain. However, improved structural correction did not consistently translate into superior clinical outcomes across studies. Adjacent fracture rates ranged widely, with some studies describing lower rates after MVA and others showing similar or higher rates, particularly in cases involving more aggressive correction. Evidence describing morbidity or mortality differences across augmentation techniques was limited, and long-term comparative data remain sparse. Overall, available findings support the feasibility and short-term safety of MVA, though heterogeneity in reporting limits firm conclusions. Conclusions: Current evidence suggests that MVA is a feasible and safe treatment option for VCFs, including complex morphologies. Although some studies report differences in radiographic correction or cement leakage patterns between MVA and KP, the clinical significance remains uncertain, and improved structural correction does not consistently translate into superior clinical outcomes. High-quality randomized trials with standardized imaging and clinical outcome reporting are needed to clarify how different augmentation strategies compare and whether structural restoration achieved with MVA leads to consistent, meaningful improvements in patient outcomes.

  PublisherDOI

• A Modified Percutaneous Spinal Cord Stimulation Implant Approach to Target the Ventral Spinal Cord

  medRxiv · 2026-04-10

  article

  Abstract Objectives Epidural spinal cord stimulation (SCS) is an emerging therapy for motor rehabilitation following spinal cord injury (SCI) and other motor disorders. Conventionally, SCS leads are placed along the dorsal spinal cord (SCS D ), where stimulation activates large diameter afferent fibers, which indirectly activate motoneurons through reflex pathways. This leads to broad activation of flexor and extensor muscles and limited fine-tuned control of motor output. Targeting the ventral spinal cord (SCS V ) may enable more direct activation of motoneuron pools, potentially improving the specificity of muscle activation; however, there is currently no established method to place leads ventrally. To address this, we evaluated the feasibility of four modified percutaneous implantation techniques to target the ventrolateral thoracolumbar spinal cord. Materials and methods Percutaneous SCS V implantation was performed in three human cadaver torso specimens under fluoroscopic guidance. The following approaches were evaluated: sacral hiatus, transforaminal, interlaminar contralateral, and interlaminar ipsilateral. The leads in the latter 3 approaches were inserted between L1 and L5. Eighteen implants were attempted, with nine leads retained for analysis. Lead and electrode position were assessed using computed tomography (CT) with three-dimensional reconstruction, along with anatomical dissection to verify lead and electrode placement within the epidural space. Results Successful ventral epidural lead placement was achieved using all four implantation approaches. The sacral hiatus (16/16 electrodes) and transforaminal (8/8 electrodes) approaches resulted in exclusively ventrolateral placement. The interlaminar contralateral approach led to 27/32 electrodes positioned ventrolaterally and 5/32 dorsally. The interlaminar ipsilateral implantation approach led to 14/32 electrodes positioned ventrolaterally and 18/32 positioned ventromedially. Conclusions These findings demonstrate that ventral epidural SCS lead placement can be achieved using modified percutaneous implant techniques. The four approaches outlined here provide a clinically feasible pathway to SCS V and establishes a foundation for future clinical studies investigating SCS V for motor rehabilitation following SCI.

  PublisherDOI

• The effectiveness of cervical medial branch radiofrequency ablation using a three-tined electrode: A real-world cross-sectional cohort study

  Interventional Pain Medicine · 2025-11-27

  articleOpen access

  Background: Cervical medial branch radiofrequency ablation (CMBRFA) using conventional electrodes is a proven treatment for chronic cervical zygapophysial (facet) joint pain. More recently, multi-tined RFA technology has been adopted in clinical practice, warranting evaluation of treatment outcomes. Objectives: Evaluate the effectiveness of CMBRFA using a three-tined RFA electrode for the treatment of cervical facet joint pain in a real-world cohort. Methods: In this cross-sectional cohort study, electronic medical records of patients who underwent CMBRFA utilizing a three-tined RFA electrode at a single academic medical center between 2022 and 2024 were reviewed. Outcomes were collected at ≥6 months post-CMBRFA via standardized telephone survey, querying numerical rating scale (NRS) pain scores, patient global impression of change (PGIC) scores, and opioid use. The primary outcome was the proportion reporting ≥50 % NRS reduction. Secondary outcomes included ≥2-point NRS reduction, PGIC scores ≥6 (indicating at least "much improved"), and pre-versus post-CMBRFA opioid use. Potential predictors of treatment success were evaluated with multivariate Poisson regression analysis. Results: 66 patients were included. At mean follow-up of 16.3 ± 7.0 months, 51.5 % (95 %CI: 39.7-63.2) reported ≥50 % NRS reduction, 77.3 % (95 %CI: 65.8-85.7) experienced ≥2-point NRS reduction, and 63.6 % (95 %CI: 51.6-74.2) had PGIC ≥6. Opioid use was decreased significantly by 15.2 % (95 %CI: 5.0-25.3). Follow-up time and repeat CMBRFA were significantly associated with outcomes for PGIC. Conclusion: In this real-world cohort, we observed clinically meaningful improvements in neck pain (defined as ≥50 % NRS reduction from baseline) in 51.5 % of participants at an average of approximately 16 months after treatment with CMBRFA using a three-tined electrode.

  PublisherDOI

• The effectiveness of fluoroscopically guided lumbar facet steroid joint injections: A systematic review

  Interventional Pain Medicine · 2025-05-09 · 2 citations

  reviewOpen access

  Summary of background data: Facet joint degeneration is a known source of chronic axial low back pain, and intra-articular steroid injections (IASI) have been used as a treatment. Objectives: To systematically review the evidence of the effectiveness of fluoroscopically guided lumbar IASI for the treatment of lumbar facet joint pain. Methods: The primary outcome was ≥50 % pain reduction at ≥ 1 month, measured by Visual Analog Scale and/or Numeric Rating Scale. Secondary outcomes included ≥30 % functional improvement on a validated functional scale. Studies including group mean improvements in pain/function without categorical reporting were also considered. Two reviewers independently screened Embase, Cochrane, PubMed Medline, Ovid Medline, Web of Knowledge, and Google Scholar. The risk of bias was assessed using the Cochrane Risk of Bias Tool, and evidence quality was evaluated using Grades of Recommendation, Assessment, Development, and Evaluation (GRADE). Results: Of the 701 publications screened, 21 met the inclusion criteria. Success rates for clinically significant pain reduction (≥50 % pain relief) ranged from 13 to 74 %, and functional improvement (≥30 % improvement) was 29 % at ≥ 1 month, based on only one study. Overall, mean improvement ranged from 11 to 59 % for pain relief and 8-58 % for function at ≥ 1 month. In the seven studies selecting patients with facet or medial branch blocks, success rates for clinically significant pain reduction (≥50 % pain relief) are reported as 13-74 % at ≥ 1 month. In this subgroup, mean pain improvement rates ranged from 23 to 67 % and functional improvement from 15 to 58 % at ≥ 1 month. According to GRADE, the overall quality of the evidence is very low due to the high risk of bias, study heterogeneity, and inconsistent methodologies. Discussion/conclusion: Pragmatic and observational studies suggest IASI may reduce pain and disability, while sham-controlled trials have not demonstrated efficacy. Given the very low quality of evidence, the true effect of IASI is highly uncertain. Further high-quality, placebo-controlled studies using standardized diagnostic criteria are needed.

  PublisherDOI

• 106. The effectiveness of basivertebral nerve radiofrequency ablation for the treatment of vertebrogenic low back pain: 12-month results of a prospective real-world cohort study

  The Spine Journal · 2025-10-09

  article
  PublisherDOI

• What is the optimal block selection paradigm for predicting a successful treatment outcome following sacral lateral branch radiofrequency neurotomy? A real-world cohort study

  Interventional Pain Medicine · 2025-06-01

  articleOpen access

  Background: Outcomes following sacral lateral branch radiofrequency neurotomy (SLBRFN) likely depend on patient selection criteria; however, commonly used criteria vary considerably. Refinement of selection criteria for SLBRFN may improve treatment outcomes. This study investigated common prognostic block-based selection criteria and treatment success following SLBRFN. Methods: In this retrospective cohort study, consecutive patients from two Canadian musculoskeletal pain management clinics who underwent SLBRFN over a 6-year period (2016-2022) were identified by electronic medical record. Patients were categorized according to several prognostic block paradigms based on number of blocks (single vs. dual), block type (lateral branch block [LBB] vs. intra-articular block [IAB]), and subsequent percentage of pain relief. Six block criteria were established: 1 = LBB/LBB≥80 %; 2 = IAB/LBB≥80 %; 3 = LBB/LBB 50-79 %; 4 = IAB/LBB 50-79 %; 5 = LBB≥80 %; 6 = LBB 50-79 %. Treatment success was assessed at three months post-SLBRFN using two criteria: (1) the primary study outcome of ≥50 % numerical rating scale (NRS) pain reduction and (2) a secondary outcome of Pain Disability Quality-of-Life Questionnaire (PDQQ) score improvement by the minimal clinically important difference (MCID). Logistic regression analyses evaluated the association between block criteria and treatment success following SLBRFN. Results: ) were included. Cohort success rates for pain and functional improvement were 43.4 % (95 % CI: 37.8-49.3) and 46.6 % (95 % CI: 40.9-52.5), respectively. After adjusting for demographics and cannula type/SLBRFN technique, none of the odds ratios for the six prognostic block paradigms showed statistical significance. Conclusion: Nearly 50 % of patients who underwent SLBRFN reported clinically significant improvement in pain and disability at three months post-procedure, regardless of prognostic block selection criteria. These results suggest that multiple block strategies may determine eligibility for SLBRFN.

  PublisherDOI

• The effectiveness of basivertebral nerve radiofrequency ablation for the treatment of vertebrogenic low back pain: 1-year results of a prospective real-world cohort study

  Pain Medicine · 2025-08-30 · 7 citations

  articleOpen access

  SUMMARY OF BACKGROUND DATA: Multiple clinical trials have demonstrated the effectiveness of intraosseous basivertebral nerve radiofrequency ablation (BVNA) for treating chronic vertebrogenic low back pain (vLBP). Few studies have evaluated the effectiveness in a real-world population. OBJECTIVES: To evaluate the effectiveness of BVNA for vLBP in a real-world population. METHODS: A single-arm prospective cohort study of patients with LBP ≥ 6 months and Type 1 or Type 2 Modic changes on MRI. The primary outcome was mean improvement in Oswestry Disability Index (ODI) post-BVNA. Secondary outcomes included the proportion of participants with (1) ≥30% and ≥15-point ODI improvements, (2) ≥2-point and ≥50% reductions in pain on Numerical Rating Scale (NRS), and (3) ≥ "much improved" on Patient Global Impression of Change (PGIC) at 3- and 12-month follow-up. RESULTS: In total, 60 participants were included (mean age 57.0 ± 13.4 years; 45.0% female). Mean ODI score improvement was 13.9 ± 18.7 and 14.0 ± 15.7 points at 3- and 12-month follow-up, respectively. At 12 months, 52.8% (95% CI, 39.7-65.6) of participants reported ≥30% ODI improvement and 39.6% (95% CI, 27.6-53.1) of participants reported ≥15-point improvement in ODI. Twelve-month responder rates for ≥2-point and ≥50% NRS improvement were 67.9% (95% CI, 54.5-78.9) and 49.1% (95% CI, 36.1-62.1). Moreover, 54.7% (95% CI, 41.5-67.3) of participants reported being "much or very much improved" on the PGIC at 12 months. DISCUSSION/CONCLUSION: In this real-world cohort, over half of participants with vLBP experienced clinically meaningful improvements in pain and function at 12-month post-BVNA. TRIAL REGISTRATION DETAILS: ClinicalTrials.gov (original study: NCT04449835; continuation study: NCT05660512); [original study: June 25, 2020; continuation study: December 13, 2022].

  PublisherOA PDFDOI

Frequent coauthors

• Taylor Burnham

  University of Utah

  55 shared

• Zachary L. McCormick

  University of Utah

  55 shared

• Masaru Teramoto

  University of Utah

  32 shared

• Zachary L. McCormick

  University of Utah

  26 shared

• Richard Kendall

  University of Utah

  23 shared

• Daniel M. Cushman

  University of Utah

  23 shared

• Beau P. Sperry

  University of California, Los Angeles

  19 shared

• Marc Caragea

  University of Utah

  16 shared

Labs

• University of Utah Department of Physical Medicine and RehabilitationPI

Education

• Other

  Pacific Northwest University of Health Sciences

• Other, Physical Medicine and Rehabilitation

  University of Utah

• Other, Interventional Spine and Musculoskeletal Medicine

  University of Utah