Basivertebral Nerve Ablation (BVN)

Basivertebral Nerve Ablation (BVN) is a minimally invasive procedure designed to relieve chronic low back pain caused by nerve signals originating within the vertebrae themselves. Using radiofrequency energy, the basivertebral nerve inside the affected vertebral body is precisely targeted and heated, stopping it from sending pain signals to the brain. This image-guided outpatient procedure provides long-lasting relief for many patients whose back pain has not improved with conservative therapies.

Quick Facts

  • Setting: Outpatient, image-guided
  • Time: ~60–90 minutes
  • Anesthesia: Local with sedation
  • Recovery: Same-day discharge; resume light activity within 1–2 days
  • Duration of relief: Long-term; many patients report sustained improvement

Who it helps

  • Chronic low back pain lasting 6 months or longer
  • Pain not improved by physical therapy, medication, or injections
  • MRI evidence of Modic Type 1 or Type 2 endplate changes (vertebrogenic pain)
  • Pain centered in the low back rather than radiating down the legs

How it works

The basivertebral nerve runs inside each vertebral body and transmits pain signals from the bone itself. Using fluoroscopic (X-ray) guidance, your provider advances a thin cannula through the vertebra’s pedicle into the area surrounding the nerve. A radiofrequency (RF) probe is then inserted through the cannula, delivering controlled heat that ablates—or deactivates—the nerve, preventing it from sending pain signals to the brain. This targeted approach addresses pain at its source without affecting nearby spinal structures.

What to expect

  • Before: You’ll lie on your stomach, and your skin will be numbed. Sedation may be given for comfort. Imaging ensures precise targeting.
  • During: A specialized cannula is guided through the vertebra’s pedicle to the basivertebral nerve. The RF probe delivers heat energy to deactivate the nerve.
  • After: A small bandage is applied, and you’ll rest briefly in recovery before going home. Most patients resume light activity within 24–48 hours and experience gradual pain relief over the following weeks.

Benefits & risks

Benefits:

  • Minimally invasive and implant-free
  • Targets the nerve responsible for vertebrogenic pain
  • Can provide durable, long-term relief
  • Outpatient procedure with short recovery time

Risks:

  • Temporary soreness or discomfort at the injection site
  • Bleeding or infection (rare)
  • Nerve or vertebral injury (rare, minimized by imaging guidance)

Is it right for me? (Checklist)

  • ✅ Chronic low back pain not relieved by other treatments
  • ✅ MRI shows Modic changes (inflammation in vertebral endplates)
  • ✅ Pain localized to the back, not primarily radiating to the legs
  • ✅ Able to undergo a minimally invasive, image-guided procedure

Alternatives at PCET

FAQs

  • What causes vertebrogenic pain? It comes from irritated nerves within the vertebral bone rather than discs, joints, or muscles.
  • When will I feel improvement? Most patients notice gradual pain relief over 4–6 weeks, with continued improvement over several months.
  • Is the nerve permanently destroyed? The targeted nerve fibers do not typically regenerate, allowing for durable pain relief.
  • How do I know if I’m a candidate? MRI evidence of Modic changes helps confirm vertebrogenic pain as the source of symptoms.
  • Is it covered by insurance? Most major insurers, including Medicare, cover BVN ablation when criteria are met.

📞 Call to Schedule

Ready to explore whether Basivertebral Nerve Ablation could help relieve your chronic back pain? Call (865) 579-0552 to schedule your appointment today.