Intracept Procedure (Basivertebral Nerve Ablation)

The Intracept procedure, also known as basivertebral nerve ablation, is a minimally invasive technique used to treat vertebrogenic pain – a type of chronic low back pain.

Vertebrogenic pain is pain originating from your vertebrae, caused by damage to the vertebral endplates (bones in your spine). Your endplates act as protective barriers between your vertebrae and spinal disks. If the endplates are inflamed or damaged, it can cause pain in the basivertebral nerve inside the vertebrae. Basivertebral nerves run through each vertebra and supply each endplate.

The Intracept procedure (basivertebral nerve ablation) uses radiofrequency to target the basivertebral nerve. Heat is applied to a specific point on the nerve, which disrupts the pain signals traveling from your spine to your brain.

What does the procedure involve?

The Intracept procedure is usually performed under a general anesthesia. You will be lying face down, and a very small incision will be made in your back. A small cannula (hollow tube) will be inserted into your spine under fluoroscopic guidance.

Very small instruments will then create a channel at the point at which the basivertebral nerve enters the vertebrae. A small radiofrequency probe is then inserted into the nerve and radiofrequency heat is applied to ablate (damage) the nerve.

The procedure takes between 45 and 60 minutes to perform. You can usually go home the same day.

What are the benefits of the Intracept procedure?

The Intracept procedure ablates the basivertebral nerve, disrupting its ability to send pain signals to the brain. As the procedure treats the pain at its source, it is effective for people with this type of chronic back pain. The procedure offers significant pain relief for many patients and improves quality of life.

The procedure offers a minimally invasive alternative to open back surgery, requiring only one very small incision and few sutures. As the procedure is less invasive, recovery times are shorter.

The results of the procedure are often long-lasting, offering some patients relief for several years.

The procedure can also reduce dependency on pain medication such as opioids.

What are the risks associated with the procedure?

Complications are rare, but may include bleeding, infection, nerve damage and increased back pain. Your doctor will discuss all the risks with you to help you decide if the treatment is right for you.

Who is the Intracept procedure suitable for?

The Intracept procedure is beneficial for patients with chronic lower back pain associated with vertebrogenic pain, for whom other treatments have been unsuccessful. These patients have pain that originates from the vertebral bodies, often made worse by movement and physical activity, but not radiating down the legs. Their pain is worse when they bend forward or sit for long periods of time.

The criteria for patients who may benefit from the Intracept procedure include:

• Chronic low back pain (more than 6 months).
• Changes in the vertebral bone marrow that are visible on MRI.
• Unsuccessful treatment with physical therapy, medications or injections.
• Absence of significant deformities (such as scoliosis or major disc herniations) that require other surgical interventions.

The procedure is suitable for people who are not candidates for traditional surgery (such as spinal fusion) but are looking for effective, long-lasting relief.

How does the Intracept procedure differ from other radioablation procedures?

A procedure called radiofrequency ablation of the medial branch nerves is another minimally invasive procedure that uses heat to treat chronic back pain. However, this procedure is not the same as the Intracept procedure.

Both procedures use radiofrequency energy to ablate nerves and reduce pain, but they address different pain sources.

Radiofrequency ablation of the medial branch nerves targets the nerves that innervate the facet joints, the small joints between the vertebrae. This procedure is used to treat facet joint-related pain and addresses pain originating from the joint structures.