Basi-Vertebral Nerve Ablation (BVNA): Part 1

Vertebrogenic pain due to degenerated or damaged vertebral endplates is a significant source of chronic low back pain.¹ The pathogenesis of vertebrogenic pain is attributed to the presence of endplates 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 leads 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, technical approach of basivertebral nerve ablation (BVNA), as well as post-procedure care and patient outcomes with representative clinical images obtained from our experience.