What is basivertebral nerve ablation?
Vertebral endplates sit between each disc and the neighbouring vertebral bone. In some people, damaged endplates are associated with a pattern of chronic central low back pain called vertebrogenic pain. MRI commonly shows Modic type 1 or type 2 changes at the affected level.
Basivertebral nerve ablation uses image guidance to reach the basivertebral nerve inside the vertebral body. Radiofrequency energy is applied to interrupt pain signals from the endplates. The procedure does not repair the disc or reverse the changes seen on MRI.
When is it considered?
This is a narrow indication, not a general treatment for back pain. It may be considered when pain has persisted despite a structured course of non-surgical care, the history and examination fit vertebrogenic pain, and the MRI findings occur at a level that plausibly matches the symptoms. Other important causes of pain should be assessed before treatment is proposed.
Limitations and alternatives
Basivertebral nerve ablation does not widen a narrowed spinal canal, stabilize an unstable segment or directly treat a compressed nerve root. Depending on the diagnosis, alternatives may include continued rehabilitation, medication, psychological support for persistent pain, targeted injections or a different procedure.
Risks and recovery
Possible risks include infection, bleeding, temporary pain flare, nerve irritation, injury along the access path and no meaningful improvement. Activity is increased gradually after the procedure. The expected stay, wound care and return to work or exercise depend on the procedure plan, your health and the physical demands of your routine.
How we approach your care
- 01
Find the true source
We begin with a thorough history and examination, supported by imaging where appropriate, to pinpoint the precise source of the problem.
- 02
Consider appropriate options
Where clinically appropriate, we consider established non-surgical options before surgery. The plan depends on the diagnosis, symptoms, health and priorities of the individual patient.
- 03
A plan built around you
Every step is explained clearly, so you always understand your options and what comes next.
This may help if
- Low back pain has persisted despite an appropriate course of non-surgical care
- MRI shows Modic type 1 or type 2 endplate changes at a level that matches the symptoms
- Examination and imaging do not indicate another dominant cause, such as nerve-root compression or marked instability
Suitability can only be assessed after reviewing your symptoms, examination, relevant imaging and previous treatment.
Common questions
What type of back pain does this procedure treat?
It is intended for a specific form of vertebrogenic pain associated with damaged vertebral endplates. It does not treat every cause of low back pain, and MRI findings must be considered alongside your symptoms and examination.
Is this the same as facet-joint radiofrequency ablation?
No. Facet radiofrequency treatment targets small nerves outside the spine that supply the facet joints. Basivertebral nerve ablation reaches a nerve within the vertebral body and is used for a different pain pattern.
What are the risks?
Possible risks include infection, bleeding, temporary pain flare, nerve irritation, injury from the access path and failure to improve. Rare complications can be more serious. Your clinician should explain how your anatomy and health affect these risks.