Analysis of Complications Associated with Basivertebral Nerve Ablation for Vertebrogenic Low Back Pain: A Multicenter Retrospective Cohort Study of 1,145 Patients

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ID: 329310
2026
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Abstract
OBJECTIVE: Low back pain (LBP) is a leading cause of pain and disability worldwide. Recent studies demonstrate a vertebrogenic model involving the basivertebral nerve (BVN) as a cause of chronic LBP. Vertebral endplates are highly innervated by the BVN, and literature shows type 1 and 2 Modic changes at vertebral endplates are a source of vertebrogenic low back pain (VBP). As a result, intraosseous radiofrequency ablation of the BVN is a minimally invasive outpatient procedure used to treat VBP. We conducted a retrospective review of 1,145 patients that have undergone BVN ablation to assess for safety and complication management. METHODS: Chart reviews were conducted to obtain demographic and pre-procedural information regarding patient gender, age at the time of BVN ablation, duration of LBP, and BMI. Post-procedure information derived from chart notes included vertebral levels ablated and post-BVN ablation complications, which were categorized as increased LBP > 7 days, increased radicular pain > 7 days, lower extremity weakness, infection, vertebral compression fracture, superficial bleeding, spinal or epidural hematoma, serious neurological injury, visit to the ER, and deep vein thrombosis/clot. RESULTS: 1,145 patient charts were reviewed showing an overall complication rate of 3.2% (37 complications). Increased radicular pain was the most common complication at 2.2% (25 complications) and resolved completely in all but one patient. The overall complication rate fell to 1.1% (13 complications) when the 24 cases of transient radicular pain were not counted as adverse events. CONCLUSIONS: In this multicenter retrospective review, the overall rate of complications related to BVN ablation was low (3.2%). The most common complication was temporary radicular pain that resolved with conservative care. These findings suggest that BVN ablation is a safe treatment for VBP in real-world clinical settings.
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Authors Bryan C. Hoelzer, Acelan Obray, Ramana Naidu, Amanda N. Cooper, Zachary L McCormick, Napatpaphan Kanjanapanang, Greg Moore, Yeng F Her, Thomas P. Pittelkow, Oludare Olatoye, Eric Freeman, Mikayla Parker, Ellie A Mitchell, Lucas Peterson, Bryson Childs, Erik Eckstrom, Petra V Ekstrom, Lindsey A Haugen, Ashley L Hamann, Grace G Carson, Alyssa S Mayeri, Candance M Peterson, Hayden E Fortin
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Journal regional anesthesia and pain medicine
Year 2026
DOI
10.1093/pm/pnag122
URL
https://doi.org/10.1093/pm/pnag122
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