Basivertebral Nerve Ablation: Part 1

Vertebrogenic pain due to degenerated or damaged vertebral endplates is a common source of chronic low back pain.¹ The pathogenesis of vertebrogenic pain is attributed to the presence of endplate nociceptors that transmit afferent signals to the basivertebral nerve (BVN), located posteriorly within the vertebral body.^2,3 Chronic endplate inflammation triggers nociceptor proliferation, and associated chemical sensitization and mechanical stimulation lead to pain signals transmitted via the BVN and perceived as low back pain.^1,2 Therefore, radiofrequency ablation of the BVN has emerged as a potential minimally invasive technique for management of vertebrogenic low back pain.^4,5 The thermal damage induced adjacent to the conducting region of the radiofrequency probe leads to interruption of pain transmission from vertebral endplates.^5,6 This video article gives an overview of the indications, procedural considerations, and technical approach of basivertebral nerve ablation, as well as postprocedural care and patient outcomes with representative clinical images obtained from our experience.