Derek S. Buck, M.D., D.C., fellowship-trained Interventional and Spine Care Specialist and Physiatrist in Pain Management at Orthopedic and Speciality Hospital in Rapid City recently reached a significant milestone in his practice after completing 100 basivertebral nerve ablation procedures.
It’s pretty significant for Dr. Buck, who will mark his five-year anniversary at Monument Health in January, because he has only been performing the procedure for two years.
Research over the previous couple of decades revealed a nerve that runs inside vertebrae called the basivertebral nerve. If the end plate that holds the nerve center becomes damaged, it can become a source of pain in the back, called vertebrogenic back pain.
“They figured out a way to actually go into the vertebrae and burn this nerve (ablation),” says Dr. Buck.
For the procedure, Dr. Buck uses a special probe to penetrate the vertebrae, and then burns the nerve for 15 minutes at 75 degrees Celsius. “The procedure is done under anesthesia in an operating room using a live X-ray fluoroscope to go back and forth between a couple of different views. It’s literally a puncture wound where we put the instruments into the bone,” he says.
There’s no stitches involved and it generally takes a total of three months to heal. The patient is under restrictions for weight, bending and twisting for two weeks following the procedure. The vertebral bone at the puncture site eventually regrows. The ablation, however, never has to be repeated, because once the nerves are burned, they don’t grow back.
Dr. Buck had been aware of basivertebral ablation and its possible benefits since around 2013. He wanted to make sure that it was properly researched, vetted and showed the right kind of consistent results, though, before he implemented it into his own practice.
“I think there’s a lot of people that would benefit from it,” he says. “It’s not one-size-fits-all. If a provider thinks they have a good candidate, they can send them to me. There are certain tests we do that are a little bit more predictive of vertebragenic back pain. If all that fits, that’s when I sit down and talk to the patients about the risks. I also inform the patient that there’s around a 17% chance they may not respond to it. I try to be very realistic because no procedure in medicine is going to give you a 100% success rate.”
Thus far the only physician at Monument Health who offers basivertebral ablation, Dr. Buck is the sole Center of Excellence in the West River region of South Dakota and was the 33rd provider in the nation to receive that distinction.
Story and Photo by Kory Lanphear