Back PAIN Basics: Providing Advanced Interventions for Non-Pharmacologic Relief in the Spine Including Medial Branch vs. Basivertebral Nerve Ablation

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Background:

Chronic spinal pain significantly impacts patient quality of life and is a leading cause of disability worldwide. Chronic spinal pain is a multifaceted condition that stems from a variety of pain generators, including degenerative disc disease, facet joint arthropathy, vertebral body pain, and sacroiliac joint dysfunction. Accurate identification of these pain sources is critical for selecting targeted, effective interventional therapies. This educational exhibit focuses on the spectrum of spinal pain generators and the corresponding advanced interventional radiology techniques used to manage them.

Clinical Findings/Procedure Details:

The exhibit will detail key pain generators, including facet joints, the basivertebral nerve (BVN), sacroiliac joints, and degenerative discs, and their clinical presentations. Special emphasis will be placed on medial branch nerve radiofrequency ablation (RFA), a well-established treatment for facet-mediated pain, and basivertebral nerve ablation, a newer technique targeting vertebrogenic pain from degenerative vertebral bodies. These procedures, along with sacroiliac joint injections, epidural steroid injections, and percutaneous discectomy, will be examined for their indications, technical nuances, and outcomes.

A comprehensive review of image-guided techniques for these interventions, utilizing fluoroscopy, CT, and MRI for precision targeting, will be provided. Clinical evidence supporting the efficacy of these treatments, including the latest randomized control trials on basivertebral nerve ablation, will be discussed, along with considerations for patient selection, post-procedural management, and long-term outcomes.

Conclusion and/or Teaching Points:

By enhancing understanding of spinal pain generators (particularly the MBNs and BVNs) and advanced interventional techniques to treat them, this exhibit aims to equip interventional radiologists with the knowledge to provide more precise, effective, and durable pain relief for patients suffering from chronic spine pain. Attendees will gain critical insights into integrating these advanced spine procedures into their practice, expanding therapeutic options for patients.