BVN Ablation Significantly Improves Pain, Function in Vertebrogenic CLBP

Classic Article Review  – Background: Chronic low back pain (CLBP) affects a substantial proportion of adults and is frequently nonspecific, contributing to inconsistent treatment pathways and suboptimal outcomes. Increasing evidence supports a vertebrogenic pain model in which damaged vertebral endplates—manifesting as Modic type 1 or 2 changes on MRI—generate nociceptive input via the basivertebral nerve (BVN). Objective: To evaluate the effectiveness of intraosseous radiofrequency ablation of the BVN compared with standard nonoperative care in patients with vertebrogenic CLBP. Design: Prospective, parallel, randomized, controlled, open-label, multicenter clinical trial conducted across 20 U.S. sites with independent data monitoring and intention-to-treat analysis. Participants: 140 adults with ≥6 months of CLBP refractory to conservative therapy, Modic type 1 or 2 changes at L3–S1, Oswestry Disability Index (ODI; 0–100 measure of disability) ≥30, and Visual Analog Scale (VAS; more...