Transforaminal Epiduroscopic Basivertebral Nerve Laser Ablation for Chronic Low Back Pain Associated with Modic Changes

Among different causes of chronic low back pain, Modic changes of the endplates have been identified as an MRI-image representation of end stage degenerative disc disease. Painful innervation of these degenerative endplates from within the vertebral body by arborization of the basivertebral nerve towards these endplates has been demonstrated. Ablation of the basivertebral nerve has been identified as one possible way to treat chronic low back pain. This chapter describes the transforaminal epiduroscopic laser ablation of the basivertebral nerve and its associated clinical outcomes.