Thermal Destruction of the Intraosseous Basivertebral Nerve (BVN) for Vertebrogenic Lower Back Pain

Thermal destruction (ablation) of the intraosseous basivertebral nerve is covered for patients with chronic lumbar low back pain (≥6 months) causing functional deficit who have failed ≥6 months of non-surgical management, have MRI evidence of Modic Type 1 or 2 changes in ≥1 vertebra from L3–S1, and lack other non-vertebrogenic causes of pain. Patients must undergo multidisciplinary screening (including psychological evaluation) with baseline pain/disability documentation; multiple clinical and radiographic exclusions apply (e.g., age ≤18, active infection, osteoporosis, radicular pain, BMI >40), and the procedure is limited to once per vertebral body in L3–S1 lifetime with up to four levels treated in one session.

"Chronic lumbar low back pain (cLBP) of ≥6 months duration causing functional deficit measured on a baseline pain or disability scale."

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