Basivertebral nerve ablation (BVNA) is a minimally invasive procedure designed to relieve chronic lower back pain. The procedure targets the basivertebral nerve, which is responsible for transmitting pain signals from the vertebral endplates—structures within the spine that are often associated with chronic back pain, particularly in cases of vertebral body endplate changes or degeneration.
Who Can Benefit from Basivertebral Nerve Ablation?
This procedure is typically recommended for patients who:
- Suffer from chronic low back pain that has persisted for at least 6 months.
- Have not found adequate relief from conservative treatments such as physical therapy, medications, or injections.
- Have been diagnosed with Modic changes, a specific type of degeneration seen in the vertebral endplates, as identified on MRI.
- Do not have significant nerve compression or spinal instability, which might require different treatments.
The Procedure
The procedure is done under a general anaesthetic or sedation.
The patient is positioned on their stomach, and a local anaesthetic is administered to numb the skin. Using xray a needle is guided into the target vertebral body (often 2-3 levels are targeted in the same procedure).
A probe is then inserted which delivers radiofrequency energy to heat and deactivate the basivertebral nerve, preventing it from transmitting pain signals.
The probe is then removed and the small incision is dressed.
Risks of Basivertebral Nerve Ablation
Infection: Although rare, there’s a risk of infection at the incision site.
Bleeding: Minimal bleeding might occur during the procedure.
Temporary Pain: Some patients may experience temporary worsening of pain before relief is achieved.
Nerve Damage: While uncommon, there is a risk of injury to surrounding nerves.
Benefits of Basivertebral Nerve Ablation
Minimally Invasive: The procedure involves a small incision and no significant disruption of tissues.
Quick Recovery: Most patients can go home the same day and return to normal activities within a few days.
Long-lasting Relief: Many patients experience significant and sustained reduction in pain following the procedure.
Reduced Medication Dependence: Successful pain relief may decrease the need for pain medications.
What to Expect After the Procedure
Immediate Post-Procedure: You will likely stay in the recovery area for a short period before being discharged on the same day.
Pain Relief: Some patients may notice immediate relief, but for others, it may take a few weeks for the full benefits to become apparent.