Basivertebral Ablation

Basivertebral Nerve Ablation (BVN) is a specialized procedure for a very specific type of back pain called vertebrogenic pain.

1. The Basics: What and Why?

• What is the basivertebral nerve (BVN)? It is a sensory nerve located inside your vertebrae (spinal bones). It carries pain signals specifically from the vertebral endplates to the brain.
• What exactly is “vertebrogenic pain”? It’s a chronic deep, aching type of back pain caused by damage or inflammation of the vertebral endplates (the interfaces between your discs and the bone).
• How does the ablation work? A doctor uses radiofrequency energy (heat) to “turn off” the BVN, preventing it from transmitting pain signals.
• Is this the same as a typical Radiofrequency Ablation (RFA)? No. Standard RFA targets nerves outside the bone (the facet joints). BVN ablation targets a nerve inside the bone. Unlike standard RFA, the BVN typically does not grow back, so the procedure is often one-time only!
  
  

2. Candidacy and Diagnosis

• How do I know if I’m a candidate? You typically need: 1) Chronic low back pain for at least 6 months, 2) Failure of conservative care (PT, meds), and 3) An MRI showing Modic changes (signs of inflammation in the bone).
• What are Modic Changes? These are specific patterns seen on an MRI that indicate the vertebral endplates are inflamed or damaged.
• Can I have this if I’ve already had spinal fusion? It depends on your hardware. If you have metal in the path of the probe, you may not be a candidate, but many patients with previous surgeries still qualify.
• Are there age limits? Age itself is rarely a limit; however, patients with severe osteoporosis or active infections may be excluded.
  
  

3. The Procedure Experience at Welia Health Hospital

• Will I be awake during the procedure? We do this in the operating room with anesthesia to ensure you are comfortable throughout the procedure.
  • For these reasons, you will need a preoperative physical with your primary medical team to say you are healthy enough for the anesthesia
• How long does it take? The procedure usually takes 45 to 90 minutes, depending on how many levels of the spine are being treated.
• Why is this done in the hospital? On top of the anesthesia and safety pieces, insurance is very strict about this being done in a hospital or outpatient surgery center. Welia has a great system that works well with getting patients great safe care relatively quickly compared to their peers.
• Will it leave a large scar? No. It is minimally invasive, involving a small incision (about the size of a pencil eraser) that is usually closed with a bandage or skin adhesive.
• Is it painful? You shouldn’t feel pain during the procedure due to anesthesia. You will likely feel some localized “soreness” at the incision site for a few days after. Some patients surprisingly have little to no pain afterward.
  • We tap a needle into the bone itself, not near any major nerves, until we get in the middle of the target bone where the BVN is. From there, it’s a 7 minute ablation before the needles are removed.
    
    

4. Recovery and Results

• How long is the recovery? Most patients return to light activity within 24 hours and full activity within 1–2 weeks (time to let the muscles and incision heal.)
• When will I feel relief? Some feel better right away, but most notice significant relief between 2 to 6 weeks. Improvement can continue for up to 3 months.
• How long do the results last? Clinical studies show that relief can last 5 years or longer. Because of the type of pain nerve destroyed inside the bone, it shouldn’t regenerate.
• What are the restrictions after and return to work? Basically don’t soak in a tub for the first 48 hours but otherwise slowly resume normal activity. OK to return to work right away knowing about the soreness. 
  
  

5. Proven Long-Term Relief (Based on 5-Year Data)

• Durable Pain Reduction: Over 66% of patients maintain a greater than 50% reduction in pain five years after the procedure.
• Pain-Free Living: Nearly 1 in 3 patients (34%) report being completely pain-free at the 5-year mark.
• High Patient Satisfaction: 74% of patients are satisfied with their results and report significant overall improvement.
• Return to Active Life: 69% of patients successfully resume the activity levels they enjoyed before their chronic back pain began.
• Drastic Drop in Medication: 65% of patients who were taking opioids prior to the procedure stopped taking them completely by year five.
• Fewer Injections: Patients saw up to a 93% decrease in the need for ongoing spinal injections.
  
  

6. Risks and Logistics

• What are the risks? Complications are rare (<0.1%) but can include infection, bleeding, nerve irritation (temporary leg pain.)
• Is it FDA approved? Yes, the technique was initially FDA cleared in 2016 but again Stryker invented the next generation technique, OptaBlate BVN, which we use at Sage, in 2025.
• Will I need an implant? No. Unlike bigger procedures or surgeries, nothing is left behind in your body after the procedure.
  
  

Is it covered by insurance? Most major insurers (including Medicare) now cover the procedure, provided you meet the specific MRI and symptom criteria.

Take the Next Step

Call our North Branch, Minnesota office to schedule a consultation with Dr. Andrew M. Clary, DO.