What Is Basivertebral Nerve Ablation (BVNA)?

Basivertebral Nerve Ablation is a minimally invasive procedure designed to interrupt pain signals carried by the basivertebral nerve in appropriately selected patients with vertebrogenic pain.

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What You'll Learn

Approx. 6–8 min read
  • What basivertebral nerve ablation is
  • Why this kind of pain may occur
  • How the procedure works, step by step
  • Which technologies are used to perform it
Why It Happens

Why Would Someone Need BVNA?

To understand BVNA, it helps to first understand where this kind of pain may come from. Follow along as a healthy segment changes over time.

  1. Step 1 of 6: A healthy disc. The discs of the spine act like shock absorbers, cushioning the vertebrae as you move.
  2. Step 2 of 6: Degeneration begins. Over time, a disc can dry out and degenerate. Its soft center shrinks, and the cushioning begins to change.
  3. Step 3 of 6: Loss of cushioning. As the disc loses water and height, it cushions the spine less effectively.
  4. Step 4 of 6: A rougher ride for the bones. When discs lose height and cushioning, the vertebral endplates may take on more stress — a rougher ride for the bones.
  5. Step 5 of 6: Modic changes on MRI. In some patients, this irritation may appear on an MRI as Modic Type 1 or Type 2 endplate changes.
  6. Step 6 of 6: The basivertebral nerve. Inside the vertebral body runs the basivertebral nerve, which can carry pain signals from these irritated endplates.
The Approach

How Does BVNA Work?

BVNA focuses on the nerve pathway that may be carrying pain — not on changing the structure of the spine.

The basivertebral nerve can carry pain signals from inside the vertebral body.

In appropriately selected patients, a probe is guided along an image-guided path toward the nerve.

The nerve pathway is treated, which may reduce the pain signal it carries.

Some patients find it helpful to think of BVNA like a root-canal concept for the spine: the goal is not to change the shape of the bone, but to interrupt a nerve pathway that may be carrying pain from inside the vertebral body.

BVNA is not described as a cure, and results vary between patients.

Candidacy

Who May Be a Candidate?

Clinicians look at several clues together — not any single finding. These may include:

Chronic axial low back pain

Persistent pain centered in the low back, rather than radiating down a leg.

Modic changes on MRI

MRI findings that may include Modic Type 1 or Type 2 endplate changes.

Symptoms despite conservative care

Pain that can persist despite a course of conservative treatment.

These clues do not make a diagnosis on their own. Only a physician can determine whether BVNA is appropriate for an individual patient, based on the history, physical examination, MRI findings, and overall clinical evaluation.

The Procedure

How Is the Procedure Performed?

BVNA is minimally invasive and image-guided. A general, patient-friendly overview of the steps:

  1. Step 1

    Planning with imaging

    Your physician reviews your history, examination, and MRI to plan the approach.

  2. Step 2

    Comfortable preparation

    The area is numbed. BVNA is performed using image guidance to help direct each step.

  3. Step 3

    Creating a small pathway

    Through a small access point, a path is gently created toward the vertebral body.

  4. Step 4

    Locating the nerve

    Image guidance helps direct the path toward the basivertebral nerve inside the bone.

  5. Step 5

    Treating the nerve pathway

    Energy is applied to interrupt the nerve pathway that may be carrying pain.

  6. Step 6

    Completion

    The instruments are removed and the small access point is closed.

Afterward

Recovery

Recovery experiences vary from patient to patient. BVNA is minimally invasive and image-guided, and your physician will explain what to expect for your specific situation. This page does not present recovery timelines as guarantees, and individual experiences differ.

Common Questions

Questions Patients Often Ask

Clear answers to a few common questions. Your physician is the best source for guidance specific to your situation.

Is BVNA surgery?

Does BVNA treat all back pain?

How do I know if I may be a candidate?

Will BVNA cure my pain?

What can I expect for recovery and results?

Technologies

Advanced Technologies Used to Perform BVNA

Both are technologies used to perform basivertebral nerve ablation — the procedure is the same.

Intracept System

Boston Scientific

A technology used to perform basivertebral nerve ablation.

  • Used to perform BVNA
  • Minimally invasive, image-guided approach
Technologies overview

OptaBlate BVN System

Stryker

A technology used to perform basivertebral nerve ablation.

  • Used to perform BVNA
  • Minimally invasive, image-guided approach
Technologies overview

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