Published by Commons Clinic. [Web version](https://commonsclinicreviews.com/articles/basivertebral-ablation-modic-changes/) Reviewer names are abbreviated. Patient reviews describe individual experiences. Review counts describe source records, not unique patients or clinical outcomes; the acquired snapshot may not include complete platform histories. Clinical education and patient accounts do not replace a consultation. Pain management # Basivertebral nerve ablation: 7 questions about the target and the evidence Basivertebral nerve ablation is discussed for a selected pattern of chronic low-back pain. A mention of Modic changes on an MRI is not enough by itself to determine whether this procedure is appropriate. Published by Commons Clinic · Updated October 21, 2026 · 4 min read [Questions to ask ↓](https://commonsclinicreviews.com/articles/basivertebral-ablation-modic-changes/#consultation-questions) [Patient experiences ↓](https://commonsclinicreviews.com/articles/basivertebral-ablation-modic-changes/#patient-experiences) In this guide 1. [Ask what source of pain is being proposed](https://commonsclinicreviews.com/articles/basivertebral-ablation-modic-changes/#guide-section-1) 2. [Put Modic changes in clinical context](https://commonsclinicreviews.com/articles/basivertebral-ablation-modic-changes/#guide-section-2) 3. [Review the full selection criteria](https://commonsclinicreviews.com/articles/basivertebral-ablation-modic-changes/#guide-section-3) 4. [Ask which evidence applies to your situation](https://commonsclinicreviews.com/articles/basivertebral-ablation-modic-changes/#guide-section-4) 5. [Compare the procedure with a continuing care plan](https://commonsclinicreviews.com/articles/basivertebral-ablation-modic-changes/#guide-section-5) 6. [Understand preparation, risks, and follow-up](https://commonsclinicreviews.com/articles/basivertebral-ablation-modic-changes/#guide-section-6) 7. [Agree on how success would be judged](https://commonsclinicreviews.com/articles/basivertebral-ablation-modic-changes/#guide-section-7) [Go to your consultation questions ↓](https://commonsclinicreviews.com/articles/basivertebral-ablation-modic-changes/#consultation-questions) [![A simplified vertebra, disc and nerve illustration alongside symptoms, examination and imaging.](https://commonsclinicreviews.com/assets/medical/disc-anatomy.webp)](https://commonsclinicreviews.com/assets/medical/disc-anatomy.webp) **Disc anatomy and your clinical picture** Original educational illustration. A simplified vertebra, disc and nerve illustration alongside symptoms, examination and imaging. Disc findings are one part of the assessment. Ask which findings fit your symptoms and which activities you want the treatment plan to help you regain. Illustration references: [Reference 1](https://www.niams.nih.gov/health-topics/back-pain/diagnosis-treatment-and-steps-to-take) · [Reference 2](https://www.nice.org.uk/guidance/ng59/chapter/recommendations) ## 1. Ask what source of pain is being proposed The procedure targets the basivertebral nerve within a vertebral body and is discussed in relation to vertebral endplate-associated pain. Ask the evaluating clinician to explain why that source is suspected in your case and how the history, examination, and imaging fit together. Start with your own symptom pattern: where pain is felt, which activities bring it on, and how it affects daily life. Ask what findings support the proposed explanation and which findings do not. A useful assessment should make room for uncertainty instead of assigning the MRI term as a complete diagnosis. Sources: [How I Do It: Basivertebral Nerve Ablation for Vertebrogenic Pain](https://asra.com/news-publications/asra-newsletter/newsletter-item/asra-news/2025/11/09/how-i-do-it--basivertebral-nerve-ablation-for-vertebrogenic-pain) ## 2. Put Modic changes in clinical context Modic changes describe particular MRI findings near vertebral endplates. The device indication includes selected patients with specified Modic findings and other eligibility criteria. Ask which findings are present and why they are relevant rather than assuming every such change needs treatment. Have the clinician point to the level on the actual image. Ask whether another finding could explain the symptoms better and what would make the team look for another cause. Keep the written report, but request an explanation of how the images influence the decision beyond the words in the report. Sources: [How I Do It: Basivertebral Nerve Ablation for Vertebrogenic Pain](https://asra.com/news-publications/asra-newsletter/newsletter-item/asra-news/2025/11/09/how-i-do-it--basivertebral-nerve-ablation-for-vertebrogenic-pain) · [Intracept Intraosseous Nerve Ablation System — indications for use](https://www.accessdata.fda.gov/cdrh_docs/pdf21/K213836.pdf) ## 3. Review the full selection criteria FDA clearance for a device concerns its specified use; it is not a promise that the procedure will help every patient with back pain. Ask the clinician to walk through the current device indication, the treatments already tried, and any features that may make the procedure unsuitable. Bring a concise record of previous care, including what was attempted, how long it was tried, and what changed. If an earlier treatment was stopped because of side effects or access problems, explain that. A meaningful review should distinguish a treatment that did not help from one that was never feasible to complete. Sources: [Intracept Intraosseous Nerve Ablation System — indications for use](https://www.accessdata.fda.gov/cdrh_docs/pdf21/K213836.pdf) · [How I Do It: Basivertebral Nerve Ablation for Vertebrogenic Pain](https://asra.com/news-publications/asra-newsletter/newsletter-item/asra-news/2025/11/09/how-i-do-it--basivertebral-nerve-ablation-for-vertebrogenic-pain) ## 4. Ask which evidence applies to your situation Request an explanation of the relevant studies, including the patients enrolled, the outcomes measured, and the duration of follow-up. Ask whether people with your other spine findings or health conditions were represented. Device clearance and a favorable patient story answer different questions from comparative treatment evidence. Focus on the outcome you need: a particular activity, more manageable symptoms, or improved function. Ask what improvement is realistic, what remains uncertain, and how the team would describe the chance of no meaningful benefit. Avoid interpreting a study average as a personalized forecast. Sources: [How I Do It: Basivertebral Nerve Ablation for Vertebrogenic Pain](https://asra.com/news-publications/asra-newsletter/newsletter-item/asra-news/2025/11/09/how-i-do-it--basivertebral-nerve-ablation-for-vertebrogenic-pain) · [Intracept Intraosseous Nerve Ablation System — indications for use](https://www.accessdata.fda.gov/cdrh_docs/pdf21/K213836.pdf) ## 5. Compare the procedure with a continuing care plan Ask what reasonable alternatives remain and what continuing nonsurgical care would involve. If a procedure is proposed, clarify what it would add to rehabilitation or other management rather than treating it as a replacement for every part of care. Discuss the burden of scheduling, transportation, recovery, and cost alongside possible benefit. If you prefer more time to decide, ask what monitoring or care is appropriate during that period. The consultation should help you compare actual options, not merely accept or reject a procedure name that appeared online. Sources: [Back Pain: Diagnosis, Treatment, and Steps to Take](https://www.niams.nih.gov/health-topics/back-pain/diagnosis-treatment-and-steps-to-take) · [Low back pain and sciatica in over 16s: assessment and management — recommendations](https://www.nice.org.uk/guidance/ng59/chapter/recommendations) ## 6. Understand preparation, risks, and follow-up Ask the procedural clinician to describe the risks relevant to the proposed technique and your health history. Share medicines, previous procedures, recent illness, and any concerns about anesthesia or infection. Obtain written instructions if you proceed; do not adapt preparation advice from a different type of injection. Before scheduling, identify who will perform the procedure and who will assess recovery. Ask what symptoms require urgent contact and how after-hours care is arranged. If more than one practice is involved, make sure the referral includes the clinical question, images, and relevant treatment history. Sources: [How I Do It: Basivertebral Nerve Ablation for Vertebrogenic Pain](https://asra.com/news-publications/asra-newsletter/newsletter-item/asra-news/2025/11/09/how-i-do-it--basivertebral-nerve-ablation-for-vertebrogenic-pain) · [Preprocedural Recommendations for Reducing Surgical Site Infections](https://asra.com/docs/default-source/guidelines-articles/2025-asra-preprocedural-recommendations.pdf?sfvrsn=16f1501d_3) ## 7. Agree on how success would be judged Choose a small number of meaningful goals and a review schedule with the treating team. Ask when it is appropriate to evaluate the result and what would prompt earlier reassessment. A lack of improvement should lead to a thoughtful review rather than an automatic sequence of additional interventions. An evaluation can help determine whether this procedure is relevant to your condition. Ask whether the evaluating clinician provides it or would recommend a referral, and discuss relevant experience, selection, alternatives, and follow-up. An understandable explanation of why a treatment fits—or does not fit—your situation is a valuable part of that assessment. Sources: [How I Do It: Basivertebral Nerve Ablation for Vertebrogenic Pain](https://asra.com/news-publications/asra-newsletter/newsletter-item/asra-news/2025/11/09/how-i-do-it--basivertebral-nerve-ablation-for-vertebrogenic-pain) · [Back Pain: Diagnosis, Treatment, and Steps to Take](https://www.niams.nih.gov/health-topics/back-pain/diagnosis-treatment-and-steps-to-take) Make the most of your visit ## Questions to bring to your consultation Choose the questions that matter most to you. Bring them along, and ask us to explain anything that is unclear. - What makes you suspect vertebral endplate-associated pain in my case? - How do my MRI findings match my symptoms and examination? - Do I meet the full current device indication and clinical selection criteria? - Which studies are most relevant to patients with my other spine findings? - What reasonable nonsurgical alternatives remain? - Who would perform the procedure and manage follow-up if I proceed? - How would we judge benefit and respond if it does not help? ## Sources & further reading - [How I Do It: Basivertebral Nerve Ablation for Vertebrogenic Pain](https://asra.com/news-publications/asra-newsletter/newsletter-item/asra-news/2025/11/09/how-i-do-it--basivertebral-nerve-ablation-for-vertebrogenic-pain) ASRA Pain Medicine - [Intracept Intraosseous Nerve Ablation System — indications for use](https://www.accessdata.fda.gov/cdrh_docs/pdf21/K213836.pdf) FDA device clearance record - [Back Pain: Diagnosis, Treatment, and Steps to Take](https://www.niams.nih.gov/health-topics/back-pain/diagnosis-treatment-and-steps-to-take) NIH / NIAMS - [Low back pain and sciatica in over 16s: assessment and management — recommendations](https://www.nice.org.uk/guidance/ng59/chapter/recommendations) NICE - [Preprocedural Recommendations for Reducing Surgical Site Infections](https://asra.com/docs/default-source/guidelines-articles/2025-asra-preprocedural-recommendations.pdf?sfvrsn=16f1501d_3) ASRA Pain Medicine We use these medical sources to help explain your options and prepare you for a conversation with our team. Our guides feature our own clinicians; patient reviews describe individual experiences. [Read as Markdown](https://commonsclinicreviews.com/articles/basivertebral-ablation-modic-changes/index.md) Meet our team ## People behind your care. [**Amandeep Bhalla, MD** Orthopedic Surgeon, Spine](https://commonsclinicreviews.com/physicians/amandeep-bhalla-md/) [More about Amandeep Bhalla ↗](https://commonsclinic.com/physicians/amandeep-bhalla-m-d/) [**Brandon A. Ortega, MD** Orthopedic Surgeon, Spine](https://commonsclinicreviews.com/physicians/brandon-ortega-md/) [More about Brandon A. Ortega ↗](https://commonsclinic.com/physicians/brandon-ortega-md/) [**Evish Kamrava, MD** Physical Medicine and Rehabilitation, Pain Management](https://commonsclinicreviews.com/physicians/evish-kamrava-md/) [More about Evish Kamrava ↗](https://commonsclinic.com/physicians/evish-kamrava-m-d/) [**Michael Port, MD** Pain Management, Anesthesiology](https://commonsclinicreviews.com/physicians/michael-port-md/) [More about Michael Port ↗](https://commonsclinic.com/physicians/michael-port-m-d/) Explore our clinicians, then talk with us about your symptoms, goals, and the care you need. Patient experiences ## Meet the clinician. *Hear the experience.* Read how patients describe their care, then bring the questions that matter to your own visit. Each portrait stays with that clinician’s accounts. [![Michael Port, MD](https://commonsclinicreviews.com/assets/michael-port-m-d.jpg)](https://commonsclinicreviews.com/physicians/michael-port-md/) ## [Michael Port, MD](https://commonsclinicreviews.com/physicians/michael-port-md/) Pain Management, Anesthesiology [Biography & all reviews →](https://commonsclinicreviews.com/physicians/michael-port-md/) [Commons Clinic profile ↗](https://commonsclinic.com/physicians/michael-port-m-d/) Excerpt > Everyone was professional, competent, caring at I felt ‘cared for’ every minute! J. Jackson Rating: 5/5 · Source: Google · Date: October 6, 2026 [Reviewer’s Google activity](https://www.google.com/maps/contrib/104219798415663791721/place/ChIJGZNjz326woARe-3UIeMPwJI) Source link type: reviewer place Attributed clinician: Michael Port, MD The reviewer shares their experience of care. Excerpt > Can't say enough good things about him and his staff. He's helped me tremendously over the years. D. Vasquez Rating: 5/5 · Source: Google · Date: September 30, 2026 [Reviewer’s Google activity](https://www.google.com/maps/contrib/111219813122786095086/place/ChIJGZNjz326woARe-3UIeMPwJI) Source link type: reviewer place Attributed clinician: Michael Port, MD The reviewer shares their experience of care. [![Amandeep Bhalla, MD](https://commonsclinicreviews.com/assets/amandeep-bhalla-m-d.jpg)](https://commonsclinicreviews.com/physicians/amandeep-bhalla-md/) ## [Amandeep Bhalla, MD](https://commonsclinicreviews.com/physicians/amandeep-bhalla-md/) Orthopedic Surgeon, Spine [Biography & all reviews →](https://commonsclinicreviews.com/physicians/amandeep-bhalla-md/) [Commons Clinic profile ↗](https://commonsclinic.com/physicians/amandeep-bhalla-m-d/) Excerpt > Dr. Bhalla is a great person and doctor. He truly cares for my health F. Ambriz Rating: 5/5 · Source: Google · Date: October 1, 2026 [Reviewer’s Google activity](https://www.google.com/maps/contrib/107417635541873824901/place/ChIJ8YAf0pAz3YARGxtBH2uG-xA) Source link type: reviewer place Attributed clinician: Amandeep Bhalla, MD The reviewer shares their experience of care. Excerpt > I was very pleased with the time the doctor spent with me and the thoughtful way he addressed my concerns. E. Bilbao Rating: 5/5 · Source: Google · Date: September 27, 2026 [Reviewer’s Google activity](https://www.google.com/maps/contrib/108620281492472690538/place/ChIJ8YAf0pAz3YARGxtBH2uG-xA) Source link type: reviewer place Attributed clinician: Amandeep Bhalla, MD The reviewer shares their experience of care. [![Evish Kamrava, MD](https://commonsclinicreviews.com/assets/evish-kamrava-m-d.jpg)](https://commonsclinicreviews.com/physicians/evish-kamrava-md/) ## [Evish Kamrava, MD](https://commonsclinicreviews.com/physicians/evish-kamrava-md/) Physical Medicine and Rehabilitation, Pain Management [Biography & all reviews →](https://commonsclinicreviews.com/physicians/evish-kamrava-md/) [Commons Clinic profile ↗](https://commonsclinic.com/physicians/evish-kamrava-m-d/) Excerpt > very friendly and helpful staff. I felt very comfortable with Dr Kamrava, he is very approachable, listens to your questions.. S. pea Rating: 5/5 · Source: Google · Date: August 11, 2026 [Reviewer’s Google activity](https://www.google.com/maps/contrib/105446668964189732316/place/ChIJi_9WeE-7woARVE5YYjWvq60) Source link type: reviewer place Attributed clinician: Evish Kamrava, MD The reviewer shares their experience of care. [![Brandon A. Ortega, MD](https://commonsclinicreviews.com/assets/brandon-ortega-md.jpg)](https://commonsclinicreviews.com/physicians/brandon-ortega-md/) ## [Brandon A. Ortega, MD](https://commonsclinicreviews.com/physicians/brandon-ortega-md/) Orthopedic Surgeon, Spine [Biography & all reviews →](https://commonsclinicreviews.com/physicians/brandon-ortega-md/) [Commons Clinic profile ↗](https://commonsclinic.com/physicians/brandon-ortega-md/) Excerpt > I had a great experience with Dr. Ortega. He is incredibly professional, attentive, and took the time to answer all of my questions thoroughly. K. Restrepo Rating: 5/5 · Source: Google · Date: April 30, 2026 [Reviewer’s Google activity](https://www.google.com/maps/contrib/102944064465154599080/place/ChIJTxvcSygz3YARoijXeBhzhh8) Source link type: reviewer place Attributed clinician: Brandon A. Ortega, MD The reviewer shares their experience of care. Keep exploring ## Your next *good question.* More guidance to help you understand your options and plan your next step. Choosing your care ### [6 questions to compare treatments around your life](https://commonsclinicreviews.com/articles/shared-decisions-treatment-options-patient-goals/) A good treatment decision connects the evidence with your life: what you hope to do, which risks concern you, and what recovery would ask of you. Your priorities belong in that discussion. [Read the guide](https://commonsclinicreviews.com/articles/shared-decisions-treatment-options-patient-goals/) Patient experience ### [A coordinated care team: 6 questions before treatment starts](https://commonsclinicreviews.com/articles/listening-explanations-and-care-coordination/) A treatment decision can involve a physician, a therapist, an imaging center, and people helping you at home. Coordination becomes easier to understand when you know who does what, how information moves, and whom to contact when something changes. Start with these five questions before the next stage of care. [Read the guide](https://commonsclinicreviews.com/articles/listening-explanations-and-care-coordination/) Pain management ### [7 questions to distinguish epidural, facet, medial branch and SI injections](https://commonsclinicreviews.com/articles/spine-injection-types-explained/) The phrase spine injection can describe different targets, medicines, and purposes. Before agreeing to one, make sure you know whether the team is testing a possible pain source, trying to relieve symptoms, or doing both. [Read the guide](https://commonsclinicreviews.com/articles/spine-injection-types-explained/) Meet the clinicians ## Explore your *next conversation.* [![Amandeep Bhalla, MD](https://commonsclinicreviews.com/assets/amandeep-bhalla-m-d.jpg)](https://commonsclinicreviews.com/physicians/amandeep-bhalla-md/) Orthopedic Surgeon, Spine ### [Amandeep Bhalla, MD](https://commonsclinicreviews.com/physicians/amandeep-bhalla-md/) Long Beach – Bixby Knolls [Meet Amandeep Bhalla](https://commonsclinicreviews.com/physicians/amandeep-bhalla-md/) [![Brandon A. Ortega, MD](https://commonsclinicreviews.com/assets/brandon-ortega-md.jpg)](https://commonsclinicreviews.com/physicians/brandon-ortega-md/) Orthopedic Surgeon, Spine ### [Brandon A. Ortega, MD](https://commonsclinicreviews.com/physicians/brandon-ortega-md/) Long Beach – Douglas Park [Meet Brandon A. Ortega](https://commonsclinicreviews.com/physicians/brandon-ortega-md/) [![Evish Kamrava, MD](https://commonsclinicreviews.com/assets/evish-kamrava-m-d.jpg)](https://commonsclinicreviews.com/physicians/evish-kamrava-md/) Physical Medicine and Rehabilitation, Pain Management ### [Evish Kamrava, MD](https://commonsclinicreviews.com/physicians/evish-kamrava-md/) Santa Monica · Long Beach – Douglas Park · Westlake Village [Meet Evish Kamrava](https://commonsclinicreviews.com/physicians/evish-kamrava-md/) [![Michael Port, MD](https://commonsclinicreviews.com/assets/michael-port-m-d.jpg)](https://commonsclinicreviews.com/physicians/michael-port-md/) Pain Management, Anesthesiology ### [Michael Port, MD](https://commonsclinicreviews.com/physicians/michael-port-md/) Marina del Rey [Meet Michael Port](https://commonsclinicreviews.com/physicians/michael-port-md/) ## Publisher & attribution Commons Clinic Reviews is operated by Commons Clinic. 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