Sustained pain relief across modic subtypes following basivertebral nerve ablation: A real-world study

Background Basivertebral nerve (BVN) ablation has emerged as a safe and effective minimally invasive treatment for patients with vertebrogenic low back pain and corresponding Modic Changes on MRI. However, real-world evidence evaluating the impact of Modic Change subtype on clinical outcomes is limited. Objective To evaluate the impact of Modic Change subtype on clinical outcomes following BVN ablation in a real-world cohort. Methods Adult patients who underwent BVN ablation at our institution from November 2019 to January 2025 were included in this retrospective study. A total of 134 patients were classified by Modic Change type on their pre-procedural MRI and stratified into Type 1 (N = 59), Type 2 (N = 52), and Mixed (N = 23) Groups. Pain severity was assessed using the Visual Analog Scale (VAS) at baseline, 4–6 weeks, 6 months, and 12 months post-procedure. Results A statistically significant decrease in VAS at 12 months was observed for the Type 1 Group (7.44 vs. 3.15, p < 0.001), the Type 2 Group (7.12 vs. 3.29, p < 0.001), and the Mixed Group (5.87 vs. 2.00, p < 0.001). At 12 months, 81.3% of the cohort achieved a ≥ 2-Point VAS decrease, with no differences between the Type 1, Type 2, and Mixed Groups. Conclusions BVN ablation produced sustained, significant pain reduction and comparable clinical outcomes across Modic Change subtypes. These findings provide real-world evidence supporting the effectiveness of BVN ablation in patients with vertebrogenic low back pain.