For some patients, chronic lower back pain originates from changes within the vertebral endplates—the areas where the bones of the spine meet the spinal discs. When these structures become damaged or inflamed, they can activate the basivertebral nerve, which carries pain signals from within the vertebrae.
Basivertebral nerve ablation is a minimally invasive procedure designed to treat this specific type of chronic lower back pain, known as vertebrogenic pain, by interrupting pain signals from the affected vertebrae.
How Does Basivertebral Nerve Ablation Work?
Using live X-ray guidance (fluoroscopy), the physician carefully accesses the affected vertebral body and positions a specialized probe near the basivertebral nerve.
Controlled radiofrequency energy is then used to heat and disable the targeted nerve, reducing its ability to transmit pain signals. The procedure targets the nerve within the vertebra and does not involve placement of a permanent implant.
Who May Benefit?
Basivertebral nerve ablation may be considered for patients with chronic lower back pain that has continued despite conservative treatment, such as medication, physical therapy, or other non-surgical care.
An MRI plays an important role in determining whether the procedure is appropriate. Certain changes in the vertebral endplates, known as Modic changes, can help identify patients whose pain may be coming from these structures.
This procedure is intended for a specific type of lower back pain and is generally not used to treat pain that primarily travels down the leg from an irritated spinal nerve, such as sciatica.
What to Expect
Basivertebral nerve ablation is a minimally invasive procedure performed using image guidance. Because the treatment addresses the nerve responsible for transmitting pain from the vertebral endplates, improvement may develop gradually following the procedure.
Recovery and response vary, and your physician will provide individualized instructions for returning to normal activities.
Targeting a Different Source of Back Pain
Chronic lower back pain can originate from several structures within the spine, and identifying the source is an important part of choosing the right treatment. For appropriately selected patients with vertebrogenic pain, basivertebral nerve ablation provides a targeted treatment option when more conservative approaches have not provided enough improvement.