Basivertebral nerve ablation significantly improves chronic low back pain

As compared to the standard care (SC), the use of basivertebral nerve ablation (BVN) ablation significantly improved pain and function, which was sustained through 12 months in chronic low back pain patients of vertebrogenic origin, a study in Regional Anesthesia and Pain Medicine concluded. Matthew Smuck and colleagues examined the clinical effectiveness of BVN ablation versus SC for chronic low back pain in patients with Modic type 1 or 2 changes with follow-up at 6 weeks, 3 months, 6 months, 9 months, and 1 year.

Following the use of BVN ablation, the SC patients were re-baselined with 6 months’ follow-up in this open-label, prospective, multicenter, parallel, randomized controlled trial [INTRACEPT]. The variation in mean Oswestry Disability Index (ODI) between the groups was the primary outcome. The Short Form (SF-36), EuroQual Group 5 Dimension 5-Level Quality of Life (EQ-5D-5L) for evaluating health-related quality of life, Visual Analog Scale (VAS) for pain assessment, responder rates, and analgesic intake were considered as secondary outcomes.

Overall, 140 patients suffering from chronic low back pain were included. At 3 months, the outcomes from BVN ablation (66 patients) were outstanding than SC (74 patients) at 3 months for the primary endpoint, VAS improvement and quality of life. At 1 year, a 25.7-point difference in mean ODI and 3.8 ± 2.7 cm VAS reduction supported BVN ablation, with 64% of patients portraying ≥ 50% decrease and 29% without pain (Figure 1):

Likewise, the earlier SC patients who selected BVN ablation (92%) revealed a 25.9±15.5 point mean ODI decrease from baseline. Opioid usage did not vary in either group. Thus, BVN ablation demonstrates better alleviation of chronic low back pain when compared to SC.