Basivertebral Nerve Ablation

If conservative treatments fail to deliver the relief you desire from your low back pain, basivertebral nerve (BVN) ablation can be an effective option. This treatment uses radiofrequency energy to heat the BVN, thereby stopping the nerve from sending pain signals.

Who is a candidate for BVN ablation?

You may be a candidate for this procedure if you have chronic axial low back pain. This means:

• You have had pain for 6 months or more
• Your pain is primarily focused in your low back, without significant radiating leg pain (sciatica)
• Your MRI shows Modic changes, which suggest inflammation and pain
• You have tried other treatments, including:
  • Physical therapy
  • Medications
  • Injections

Discogenic, or vertebrogenic low back pain is traditionally difficult to treat, and historically has been managed medically or by surgical intervention such as a fusion. Fortunately now, we are thrilled to be able to offer this procedure as an alternative.

The BVN Ablation Procedure

Before undergoing the BVN ablation procedure, you must complete the preoperative process, which includes:

• An evaluation with Dr. Bainbridge to determine if you would benefit from the procedure
• Updated imaging (MRI and xrays)
• DEXA scan, to evaluate if you have osteoporosis

Once you have completed this process, we will submit a preauthorization request to your insurance company. This procedure is relatively new and not all insurance companies will approve this. Our team will discuss the insurance authorization process in detail and guide you through it every step of the way. Once the determination from your insurance company is received, you will be scheduled for the BVN ablation procedure.

The BVN ablation procedure takes place at an outpatient surgery center, and takes 1-2 hours depending on how many vertebral levels Dr. Bainbridge determines need to be treated. A small incision is made in your lower back to access the target vertebrae. Then, using fluoroscopic (x-ray) guidance, a special needed is guided into the center of the vertebra to access the BVN. The needle is then removed and a specialized radiofrequency catheter is advanced. Once the correct placement is confirmed, the tip of the catheter is heated to stop the BVN from transmitting pain signals. After the procedure is complete, all of the surgical tools are removed, the incision is closed, and you will be moved to the recovery area for approximately 45 minutes.

You may feel some post-procedural soreness afterwards, for up to 1-2 weeks. Some people feel better very quickly, for some people the relief occurs more gradually. Your care team will council you on expectations for healing, as well as precautions to take during this time.