What it is:
Basivertebral nerve (BVN) ablation is a minimally invasive, outpatient procedure used to treat a specific type of long-lasting low back pain. It works by calming a single nerve — the basivertebral nerve — that carries pain signals from the “endplates,” the top and bottom surfaces of your spinal bones (vertebrae). When these endplates become worn or inflamed, this nerve can send steady pain signals to your brain. Using controlled heat energy (radiofrequency), the procedure interrupts those signals at their source.
Importantly, this is not spine surgery. Nothing is removed, fused, or permanently implanted, and it does not change the structure or stability of your spine.
This procedure is designed for people who have:
- Low back pain lasting 6 months or longer
- Pain that has not improved with conservative care such as physical therapy, exercise, and medications
- A specific pattern of endplate changes (called “Modic changes”) seen on an MRI scan
Dr. Badiyan will review your history, examination, and MRI to decide whether this treatment is right for you. It is not appropriate for everyone — for example, it is generally not used during pregnancy, in the presence of active infection, certain fractures, tumors, or after prior surgery at the same level of the spine. Dr. Badiyan will discuss whether you are a good candidate.
How the procedure works:
The procedure is performed by Dr. Badiyan using live X-ray for precise guidance. In general:
- You lie face down, and the skin over your lower back is numbed with local anesthetic. IV sedation be used for comfort.
- Using imaging guidance, Dr. Badiyan passes a thin instrument through a small opening in the back part of the spinal bone to reach the center of the vertebra, where the basivertebral nerve travels.
- A small heated probe delivers radiofrequency energy for a few minutes to gently interrupt the nerve.
- The instrument is removed, and the small skin opening is covered with a bandage — no stitches are usually needed.
The procedure often takes roughly 30 minutes to an hour depending on how many levels are treated, and most people go home the same day.
What to expect afterward:
Most people return home the same day and can gradually resume normal activities. Some soreness at the treatment site is common for a short time. Because pain relief comes from calming the nerve, some people notice improvement over the weeks following the procedure rather than immediately.
How well it works:
Studies have shown that many people experience meaningful, lasting relief in both pain and daily function. In clinical trials, a large share of patients reported at least a 50% reduction in pain, and improvements have been shown to last for years — with follow-up studies reporting sustained benefit at 5 years and beyond. Results vary from person to person, and not everyone responds. Your doctor can help set realistic expectations for your situation.
Possible risks:
BVN ablation has a strong safety record in studies, with few serious complications reported. As with any procedure involving the skin and spine, there is a small risk of bleeding, infection, or temporary soreness. Dr. Badiyan will review the specific risks and benefits with you before the procedure.
