Episode # 79 • 17 Jun 2025
Managing Vertebrogenic Pain: Ablation Procedures & Outcomes
Paging all neuroradiologists and spine specialists interested in enhancing their vertebral nerve ablation practice. In this special ESNR edition of Backtable MSK, host Jacob Fleming welcomes neuroradiologist Dr. Luigi Manfre to discuss the intricacies of vertebral nerve ablation, focusing on patient selection, technical approaches, and emerging practice trends.
Timestamps
00:00 - Introduction
02:43 - Upcoming Hands-On Spine Course
08:40 - The Rundown: Basivertebral Nerve Ablation
15:18 - Understanding Modic Changes and Their Implications
26:03 - Unique Innervation and Corresponding Challenges in Ablation
38:13 - Technical Approaches and Difficulties in BVNA
51:16 - Patient Selection and Procedure Efficacy for Ablative Procedures
01:00:29 - Conclusion and ESNR Course Information
Resources
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More about this episode
The physicians discuss the importance of careful diagnosis using MRI, SPECT scanning, and nerve block tests to improve treatment efficacy. Dr. Manfre emphasizes the need for strict patient selection to mitigate failures and highlights the variability in vertebral innervation between patients that can affect outcomes. The conversation also explores the nuances of conducting procedures under CT guidance and addresses challenges in treating different spinal levels, including L5 and S1. BONUS: Details on the ESNR Hands-On Spine Course held in Catania, Italy from October 16th-18th, 2025.
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