Chapter 9 - Basivertebral nerve ablation

Abstract

Chronic low back pain (CLBP) is one of the most common health conditions and one of the leading causes of disability worldwide. Treatment for low back pain is typically conducted in a stepwise approach. Initial treatment starts with conservative nonpharmacologic measures such as education, increased activity, and physical therapy. With the persistence of back pain, pharmacological therapies and interventional approaches such as spinal cord stimulation or spinal surgery are additional treatment modalities for CLBP. Despite these approaches, recent research has suggested that a major source of back pain can be from vertebrogenic origins, as vertebral discs degenerate over time. Studies have shown that the basivertebral nerve may carry nociceptive signals from vertebral end plates and result in CLBP. An approach to target the basivertebral nerve includes radiofrequency ablation of the nerve to decrease pain. Our chapter presents the stepwise approach for conducting a basivertebral nerve ablation and discusses research studies and results on the use of the procedures.