Basivertebral Nerve Radiofrequency
Percutaneous treatment of vertebrogenic chronic low back pain — associated with Modic changes — performed inside the vertebra, without open surgery.
What it is
Vertebrogenic low back pain originates in the vertebral endplates — the surfaces of the vertebra in contact with the disc — and is associated with Modic changes visible on MRI. The basivertebral nerve, which enters the vertebral body through its posterior wall, is responsible for transmitting this pain. Basivertebral nerve radiofrequency is a percutaneous procedure in which a probe-needle is positioned inside the vertebra, under image guidance, to deactivate this nerve and stop pain transmission at its source. Dr. Miguel Cordeiro introduced this technique in Europe.
Who it is for
- Chronic low back pain for more than 6 months
- Modic changes (type 1 or 2) on MRI
- Pain that has not responded to medication, physiotherapy or injections
- No nerve compression requiring surgery
- Patients seeking an alternative to spinal fusion surgery
How it works, step by step
- 1
Clinical and imaging assessment (MRI) to confirm the vertebrogenic origin of pain
- 2
Outpatient procedure, under local anesthesia and light sedation
- 3
Transpedicular access to the vertebra, guided by CT or fluoroscopy, with millimetric precision
- 4
Radiofrequency applied to the basivertebral nerve for a few minutes
- 5
Same-day discharge, without hospitalisation
Scientific evidence
The technique has been validated by sham-controlled randomized clinical trials, published in journals such as the European Spine Journal and World Neurosurgery, which demonstrated significant improvements in pain and function in selected patients — with results maintained at 2- and 5-year follow-up. The technology holds CE marking and FDA clearance (2016). No individual outcome can be guaranteed, but the available evidence is among the strongest in chronic low back pain treatment.
Recovery
Discharge takes place the same day. Pain relief is progressive: most patients report significant improvement within the first 4 to 12 weeks, consolidating over the following months. Return to light activities is usually quick, with an individualised follow-up plan.