Intracept Procedure (Basivertebral Nerve Ablation)
Chronic low back pain is one of the most common and debilitating conditions worldwide. While many cases are attributed to degenerative disc disease, facet joint arthritis, or muscular strain, a significant subset of patients suffer from vertebrogenic pain—a distinct and often underdiagnosed cause of chronic low back pain.
Vertebrogenic pain originates from damage and inflammation within the vertebral endplates, the thin layers of cartilage and bone that separate the spinal discs from the vertebral body. The basivertebral nerve (BVN), which innervates these endplates, plays a crucial role in transmitting pain signals from damaged vertebral structures.
In the past, treatment options for chronic low back pain were limited, often involving long-term medication use, physical therapy, spinal injections, or even surgery. However, basivertebral nerve ablation using the Intracept® procedure has emerged as an effective, minimally invasive solution for patients suffering from vertebrogenic pain.
Recognizing Vertebrogenic Pain: Symptoms and Diagnosis
Patients with vertebrogenic pain often present with specific characteristics that distinguish it from other types of low back pain:
✅ Deep, aching pain in the midline lower back (typically L3-S1 vertebrae).
✅ Pain worsens with prolonged sitting, bending, or activity.
✅ Pain is not primarily related to disc herniation, radiculopathy (sciatica), or facet joint arthritis.
✅ MRI findings show Modic type 1 or type 2 changes in the vertebral endplates, indicating inflammation and degeneration.
Vertebrogenic pain is diagnosed based on clinical symptoms and MRI imaging, which reveal characteristic Modic changes—a key indicator of vertebral endplate inflammation and BVN irritation.
Traditional Treatment Options for Chronic Low Back Pain
Before the advent of basivertebral nerve ablation, patients with vertebrogenic pain were typically managed using conventional treatments, which include:
Physical Therapy & Core Strengthening – Helps improve spinal stability but may not address the root cause of vertebrogenic pain.
Medications (NSAIDs, Muscle Relaxers, Opioids) – Provide temporary relief but do not offer a long-term solution.
Epidural or Facet Joint Injections – May help some patients but are not targeted for vertebrogenic pain.
Spinal Fusion Surgery – A last-resort option that is invasive and has mixed outcomes for patients with vertebrogenic pain.
Since these options do not directly target the source of vertebrogenic pain—the basivertebral nerve, they often result in incomplete or temporary pain relief.
The Intracept® Procedure: A Game-Changing Solution for Vertebrogenic Pain
How Basivertebral Nerve Ablation Works
The Intracept Procedure is a minimally invasive, FDA-approved treatment designed to disrupt pain transmission from the basivertebral nerve inside the vertebral body. The procedure involves:
Targeting the Basivertebral Nerve (BVN)
Using fluoroscopic guidance, a specialized radiofrequency probe is inserted into the affected vertebra through a small incision.
Ablation of the BVN
Controlled radiofrequency (RF) energy is applied to thermally ablate the basivertebral nerve, preventing it from transmitting pain signals.
No Hardware, No Implants
Unlike spinal fusion, Intracept preserves natural spinal motion and does not require hardware or implants.
Benefits of the Intracept Procedure
✔ Long-Lasting Pain Relief – Clinical studies show significant pain reduction lasting five years or more after the procedure (1).
✔ Minimally Invasive – No spinal implants, no large incisions, and a quick outpatient recovery.
✔ Targets the Root Cause – Unlike injections or medications, which provide temporary relief, Intracept addresses the pain at its source by disrupting BVN activity (2).
✔ Improves Function and Quality of Life – Patients experience reduced pain and increased mobility within weeks of the procedure (3).
✔ Avoids More Invasive Surgeries – Many patients who undergo Intracept can avoid unnecessary spinal fusions or long-term opioid use.
Who Is a Candidate for the Intracept Procedure?
Patients with chronic, refractory low back pain may be ideal candidates for basivertebral nerve ablation if they:
✅ Have experienced chronic low back pain for at least six months.
✅ Have not responded to physical therapy, medications, or injections.
✅ Show Modic type 1 or 2 changes on MRI at L3-S1.
✅ Have midline lower back pain rather than nerve-related (radicular) pain.
Clinical Evidence Supporting Intracept
Several landmark studies have demonstrated the effectiveness of basivertebral nerve ablation:
📌 SMART Trial (2019): Patients who underwent Intracept showed significant pain relief and functional improvement compared to non-surgical management (4).
📌 5-Year Follow-Up Study (2021): Demonstrated that pain relief was sustained long-term, with over 70% of patients reporting significant improvement (5).
📌 Long-Term Outcomes (2023): Confirmed that basivertebral nerve ablation provided superior pain reduction compared to standard non-operative treatments (6).
Conclusion: Is Intracept Right for You?
The Intracept Procedure is revolutionizing the treatment of vertebrogenic pain, offering long-lasting relief for patients suffering from chronic low back pain caused by vertebral endplate inflammation.
For individuals who have tried and failed conventional treatments, Intracept provides a minimally invasive, scientifically proven solution that directly targets the basivertebral nerve—addressing the root cause of their pain.
If you or a loved one suffers from chronic, midline low back pain that has not improved with conservative treatments, you may be a candidate for basivertebral nerve ablation.
Want to learn more? Contact our office today at (435) 714-7180 to see if the Intracept Procedure is right for you!
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References
Fischgrund JS, et al. Basivertebral nerve ablation for the treatment of chronic low back pain: Five-year outcomes.
Khalil JG, et al. Intracept basivertebral nerve ablation for chronic vertebrogenic pain: Clinical outcomes and evidence.
Smuck M, et al. Pain relief and functional improvement following BVN ablation. SAGE Journals
SMART Trial. Clinical evaluation of BVN ablation for vertebrogenic pain.
Becker S, et al. Prospective randomized study of BVN ablation vs. sham control. LWW