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Over my last two posts I discussed how doctors diagnose back pain that is caused by irritation of the nerve that innervates the vertebrae. It is great that doctors now have a better understanding of one of the many causes of back pain but what do we do with this knowledge?
There is a new surgical procedure designed to treat the pain caused by irritation of the basivertebral nerve as a result of the stress induced by degeneration of the disc.
It is a very minimally invasive procedure that takes less than an hour that is performed as an outpatient - meaning that you go home the same day, It can be performed under general anesthesia or heavy sedation (like a colonoscopy). The procedure involves a small incision, smaller than a number 2 pencil into which a wicked large needle (Sorry I live in the Boston area) is inserted into each of the vertebrae that display the Modic changes on the MRI.
A small probe is then inserted to the portion of the vertebrae where the nerve fibers are. The tip of the probe is then heated with radio waves to a specific temperature for a specific amount of time which destroys the nerve.
The process of destroying (ablation) something using radio waves (radio frequency) is called radio frequency ablation. This technique is used in other areas of medicine to destroy tumors and nerves that cause pain so it has been well studied and there are very few complications associated with it.
The next question should be does it work and for how long? Multiple studies have demonstrated significant pain relief for up to 5 years after the procedure. It is important to note that the pain relief is not immediate. There is some inflammation following the procedure so it takes a couple of weeks the pain to go away. However, the pain that patients experience is far less than the pain experienced from a spinal fusion.
Sooo - How do you know if you are a candidate for this procedure?
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