A Minimally Invasive Treatment for Certain Types of Chronic Low Back Pain
Chronic low back pain can have many different causes, and finding the source of pain is an important part of choosing the right treatment.
For some patients, the pain may come from damage and changes in the vertebral endplates—the areas where the discs meet the vertebrae. This type of pain is known as vertebrogenic low back pain.
Basivertebral Nerve Ablation (BVNA) is a minimally invasive procedure designed to treat vertebrogenic low back pain by targeting the basivertebral nerve, which carries pain signals from the vertebral endplates.
At Kansas Pain Management, our physicians evaluate your symptoms, medical history, physical examination, and imaging to determine whether BVNA may be appropriate for your condition.
Basivertebral Nerve Ablation (BVN)
Basivertebral Nerve Ablation is a minimally invasive treatment that uses radiofrequency energy to disrupt pain signals carried by the basivertebral nerve inside the vertebral body.
The basivertebral nerve supplies the vertebral endplates and can transmit pain signals associated with damaged or inflamed endplates.
By targeting this nerve, BVNA is intended to reduce the transmission of pain signals associated with vertebrogenic low back pain.
BVNA is different from treatments that target the facet joints, spinal nerves, or other structures of the spine. The appropriate treatment depends on what is causing your pain.
What Is Vertebrogenic Low Back Pain?
Not all low back pain comes from the same source.
The vertebral endplates can become damaged or undergo degenerative changes over time. These changes may be associated with inflammation and changes within the bone marrow next to the endplates.
When these changes involve the nerves supplying the vertebral endplates, they may contribute to a specific type of chronic low back pain called vertebrogenic pain.
This pain is generally located in the lower back and may be more noticeable with activities such as:
- Sitting for extended periods
- Bending forward
- Flexing the lower back
- Moving from sitting to standing
- Performing activities that place stress on the front portion of the spine
Some patients experience pain primarily in the middle of the lower back with limited radiation into the legs.
However, symptoms can overlap with other spinal conditions. A thorough evaluation is necessary to determine the likely source of your pain.
What Role Does an MRI Play?
MRI imaging can help physicians identify changes in the vertebral endplates and the surrounding bone marrow.
One type of MRI finding associated with vertebral endplate changes is called a Modic change.
Modic changes are commonly described as three types:
Modic Type 1
These changes are associated with inflammation and bone marrow edema around the vertebral endplates.
Modic Type 2
These changes are associated with fatty replacement of the bone marrow near the endplates.
Modic Type 3
These changes are associated with sclerosis, or hardening of the bone.
For patients being considered for BVNA, Modic Type 1 or Type 2 changes may be an important part of determining whether the pain is related to the vertebral endplates.
An MRI finding alone does not necessarily mean that BVNA is appropriate. Your physician will consider your symptoms, examination, imaging, and other possible causes of back pain.
How Does Basivertebral Nerve Ablation Work?
BVNA focuses on the basivertebral nerve within the vertebral body.
During the procedure, the physician uses image guidance to access the appropriate area of the vertebra. Radiofrequency energy is then used to treat the basivertebral nerve.
The goal is to interrupt pain signaling associated with the affected vertebral endplates.
Because chronic low back pain can have multiple causes, BVNA is intended for carefully selected patients whose symptoms and imaging findings are consistent with vertebrogenic pain.
Who May Be a Candidate for BVNA?
BVNA may be considered for patients who have:
- Chronic low back pain lasting at least six months
- Limited or no improvement after appropriate conservative treatment
- MRI findings consistent with vertebral endplate changes
- Pain that is primarily axial, meaning it is centered in the lower back
- Pain that may worsen with sitting, bending forward, or flexion-based activities
- Little or no pain caused primarily by nerve irritation traveling into the leg
Your physician will also evaluate whether another condition better explains your symptoms.
When May Another Treatment Be More Appropriate?
BVNA is not intended to treat every type of low back pain.
Other treatment options may be considered when symptoms are primarily related to conditions such as:
- Nerve compression or radicular pain
- Significant disc herniation
- Spinal stenosis
- Vertebral compression fracture
- Certain forms of spondylolisthesis
- Other conditions affecting the discs, facet joints, sacroiliac joints, or spinal nerves
This is why identifying the source of your pain is an important first step.
What Happens During the Procedure?
Basivertebral Nerve Ablation is performed as a minimally invasive procedure.
Before treatment, your physician will review your symptoms and imaging to identify the vertebral levels that may be contributing to your pain.
During the procedure:
- You will be positioned and prepared for treatment.
- The physician uses imaging guidance to safely access the targeted vertebral area.
- The basivertebral nerve is located within the vertebral body.
- Radiofrequency energy is used to treat the targeted nerve.
- You will be monitored during and after the procedure.
The exact approach and anesthesia or sedation used will depend on your individual circumstances and the physician’s recommendations.
What Can I Expect After BVNA?
Recovery can vary from patient to patient.
Your physician will provide specific instructions regarding activity, medications, and follow-up after the procedure.
Some patients may notice improvement relatively early, while for others the improvement may develop gradually.
Your physician will monitor your progress and determine whether additional treatment or follow-up is appropriate.
What Are the Potential Benefits?
For appropriately selected patients with vertebrogenic chronic low back pain, BVNA may provide meaningful improvement in pain and physical function.
Clinical studies of BVNA have reported improvements in pain, function, and quality of life that have been maintained over extended follow-up periods.
Results vary from person to person, and no procedure can guarantee a specific level or duration of pain relief.
The potential benefit of BVNA depends in part on whether the basivertebral nerve and vertebral endplates are actually contributing to your pain.
Is BVNA the Same as Radiofrequency Ablation for the Facet Joints?
No.
Although both treatments use radiofrequency energy, they target different nerves and different sources of pain.
Facet radiofrequency ablation targets nerves associated with the facet joints.
Basivertebral Nerve Ablation targets the basivertebral nerve within the vertebral body and is intended for vertebrogenic low back pain associated with vertebral endplate changes.
Your physician can help determine which treatment, if any, is appropriate based on the suspected source of your pain.
Is BVNA the Same as Spinal Fusion?
No.
Basivertebral Nerve Ablation and spinal fusion are very different procedures.
BVNA is a minimally invasive nerve-targeting procedure intended to reduce pain signaling associated with vertebrogenic pain. Spinal fusion is a surgical procedure that joins vertebrae together to address specific structural problems.
Whether either procedure is appropriate depends on the underlying condition causing your symptoms.
Does BVNA Treat Sciatica?
BVNA is not primarily intended to treat pain caused by nerve compression or irritation that travels from the lower back into the leg.
If your symptoms are primarily radicular, your physician may evaluate other possible causes and discuss treatments that are more appropriate for that condition.
How Long Should I Have Back Pain Before Considering BVNA?
Patients being considered for BVNA generally have chronic low back pain that has continued for at least six months despite conservative treatment.
However, duration alone does not determine whether you are a candidate.
Your symptoms and MRI findings must also be consistent with vertebrogenic pain, and other potential causes should be evaluated.
How Do I Know If My Pain Is Vertebrogenic?
There is no single symptom that confirms vertebrogenic pain.
Your physician may consider:
- Where your pain is located
- How your pain behaves with sitting and movement
- Whether bending or flexion increases your symptoms
- Your physical examination
- Your response to previous treatments
- MRI findings involving the vertebral endplates
- Whether other spinal conditions better explain your symptoms
A complete evaluation is important before deciding whether BVNA is appropriate.
Is Basivertebral Nerve Ablation Right for Me?
BVNA may be an option for some patients with chronic vertebrogenic low back pain, but it is not appropriate for everyone.
At Kansas Pain Management, our physicians can review your symptoms and imaging and discuss whether the treatment fits your specific condition.
If another source is contributing to your pain, we can also discuss other treatment options that may be more appropriate.
Insurance and Coverage
Insurance coverage for Basivertebral Nerve Ablation can vary depending on your insurance plan, medical history, diagnosis, and individual coverage requirements.
Some insurance plans may require documentation of previous conservative treatment or prior authorization before the procedure.
Our team can help you understand the next steps and determine what information may be needed from your insurance provider.
Why Choose Kansas Pain Management?
Chronic back pain can affect your mobility, work, sleep, and everyday activities.
At Kansas Pain Management, treatment begins with understanding the source of your pain. Our physicians use your medical history, physical examination, imaging, and previous treatment response to develop an individualized treatment plan.
If your symptoms and imaging suggest vertebrogenic low back pain, Basivertebral Nerve Ablation may be one of the treatment options to consider.
Take the Next Step for Chronic Low Back Pain
If you have experienced chronic low back pain that has not improved with conservative treatment, an evaluation may help identify the source of your symptoms.
Contact Kansas Pain Management to schedule an evaluation and find out whether Basivertebral Nerve Ablation may be appropriate for you.
Related Conditions and Treatments
- Low Back Pain
- Vertebrogenic Low Back Pain
- Radiofrequency Ablation
- Epidural Steroid Injections
- Spinal Cord Stimulation
- SI Joint Pain
- SI Joint Injections
FAQs
Basivertebral Nerve Ablation is a minimally invasive procedure that uses radiofrequency energy to treat the basivertebral nerve associated with certain types of chronic vertebrogenic low back pain.
BVNA is intended for appropriately selected patients whose chronic low back pain is associated with vertebral endplate changes and is consistent with vertebrogenic pain.
Modic Type 1 and Type 2 changes involving the vertebral endplates can be important findings when evaluating a patient for BVNA.
Patients being considered generally have chronic low back pain lasting at least six months and have not responded adequately to conservative treatment.
No. The two procedures target different nerves and different potential sources of back pain.
BVNA is a minimally invasive procedure and is different from traditional spinal surgery such as spinal fusion.
BVNA is not primarily intended for pain caused by nerve compression or irritation. Your physician will evaluate whether your symptoms are consistent with vertebrogenic pain or another condition.
Studies have reported sustained improvements in pain and function over several years in appropriately selected patients. Individual results vary.
Coverage varies by insurance plan. Some patients may need prior authorization or documentation of previous conservative treatment.
The first step is an evaluation by a qualified pain specialist. Your physician can review your symptoms, examination, MRI findings, and previous treatments to determine whether BVNA may be appropriate.
Treatment Offered By Kansas Pain Management
Kansas Pain Management offers a comprehensive pain treatment plan that is tailored to each patient’s specific needs. The first step is a thorough evaluation, which includes a medical history, physical examination, and diagnostic testing, if necessary.
Treatment options may include medications, physical therapy, injections, or surgery, depending on the underlying cause of the pain.
Kansas Pain Management also offers a range of minimally invasive procedures to help alleviate pain and restore function. With board-certified and fellowship-trained physicians, Kansas Pain Management is committed to providing the highest quality care for patients suffering from pain. You can book an appointment with us at Overland Park, Lawrence, Leavenworth/Lansing, Roeland Park, etc. We also serve nearby locations like Ottawa, Missouri, Topeka, Belton, Manhattan, Lee’s Summit, Johnson County & Kansas areas.