Intracept Procedure (Basivertebral Nerve Ablation)
The Intracept procedure — also called basivertebral nerve ablation — is a minimally invasive treatment for people with certain types of chronic low back pain. Providers often recommend it when other treatments like medication, injections and physical therapy don’t work.
The Intracept® procedure — also called basivertebral nerve ablation — is a minimally invasive treatment for people with vertebrogenic pain (a specific type of chronic low back pain).
Vertebrogenic pain literally means pain that begins in (“genic”) your vertebra (“vertebro”). It occurs when there’s damage to the endplates of your vertebrae (the bones in your spine). Your endplates are protective barriers located between your vertebrae (made of hard bone) and your spinal disks (made of cushiony, gel-filled cartilage). They also carry blood and nutrients to your disks. Damaged end plates can trigger pain at the basivertebral nerve inside your vertebrae.
Your basivertebral nerves run through the bone of each vertebra and branch off to supply each endplate. That’s why vertebrogenic pain is so specific.
The Intracept procedure uses radiofrequency energy to heat a narrow point on your basivertebral nerve. That disrupts pain signals that travel from your spine to your brain, offering relief from vertebrogenic pain.
Healthcare providers often recommend the Intracept procedure when nonsurgical options like medications, injections or physical therapy aren’t effective enough. It’s a less-invasive alternative to open spinal surgery.
Providers typically use general anesthesia for the Intracept procedure, so you’ll need to arrange for a loved one to drive you to and from your appointment. You should also tell your healthcare provider about any medications or supplements you’re taking. They’ll let you know if you need to stop any medications before your visit.
A healthcare provider will ask you to lie face down on an exam table. They’ll give you general anesthesia to make sure you’re comfortable before beginning the procedure. Then, your healthcare provider will:
- Create a small incision in your back.
- Use fluoroscopy to guide a thin, hollow tube (cannula) through the incision and into your vertebra.
- Use tiny instruments to create a channel to where the basivertebral nerve enters your vertebrae.
- Insert a small radiofrequency probe through the channel and directly into the trunk of your basivertebral nerve.
- Use radiofrequency heat to ablate (damage) the basivertebral nerve.
- Remove the instruments and close your incision with sutures.
The Intracept procedure usually takes between 60 and 90 minutes to complete. It’s an outpatient procedure. You should be able to go home once your sedation wears off.
Your healthcare provider will let you know about any restrictions following your Intracept procedure. In general, it’s a good idea to rest as much as possible and avoid exercise for about 48 hours.
Typical Intracept procedure side effects include slight soreness around your incision for a few days. Some people may develop bruising and minor swelling, as well. You can usually manage these side effects with over-the-counter (OTC) pain relievers like acetaminophen or ibuprofen . Your healthcare provider will also give you a detailed list of post-treatment instructions.
The Intracept procedure offers several advantages for qualifying candidates:
- Minimally invasive: The Intracept procedure is a minimally invasive alternative to open back surgery. It requires one incision and very few sutures.
- Effective for vertebrogenic pain: Because the Intracept procedure treats pain at its source (your basivertebral nerve), it can be quite effective for people with this specific type of chronic back pain.
- Long-lasting results: Studies show that most people who undergo the Intracept procedure have significant reduction in pain that lasts five years or longer.
- Shorter recovery time: Because the Intracept procedure is less invasive than traditional back surgery, most people fully recover in one to two weeks.
Research suggests that the Intracept procedure is an effective and reliable treatment for people with vertebrogenic pain. In one 2023 study:
- 65% of people reported at least a 50% reduction in back pain.
- 36.2% of people reported at least a 75% reduction in back pain.
- 22.4% of people reported 100% pain relief six months after the procedure.
If you’ve had chronic back pain for at least six months with no improvement from conventional treatments, ask your healthcare provider about the Intracept procedure. They can determine if you’re a candidate.
While complications aren’t common, they can happen after any surgical procedure. Possible Intracept procedure complications include:
- Bleeding.
- Infection.
- Nerve damage.
- Increased back pain.
To learn more about Intracept procedure pros and cons, talk to your healthcare provider. They can tell you if this treatment is right for you.
Most people make a full recovery in about one to two weeks. You may be able to return to work or school as early as two or three days after the procedure. If you have a physically demanding job, you may need to take a few more days off work.
Recovery times can vary depending on your unique situation. Your healthcare provider can tell you what to expect in your case.
When should I call my healthcare provider?
If you’ve recently had the Intracept procedure, be sure to call your healthcare provider if you develop signs of infection, including:
- Fever over 101 degrees Fahrenheit (38.3 degrees Celsius).
- Chills.
- Warmth or expanding redness around your incision.
- Drainage from the incision site.
- Swelling that gets worse after the third or fourth day.
- Pain that doesn’t get better with medication.
References
- Eshraghi Y, Shah JD, Guirguis M. Novel Technologies in Interventional Pain Management (https://pubmed.ncbi.nlm.nih.gov/35526983/). Phys Med Rehabil Clin N Am. 2022 May;33(2):533-552. Accessed 11/6/2023.
- Nwosu M, Agyeman WY, Bisht A, et al. The Effectiveness of Intraosseous Basivertebral Nerve Ablation in the Treatment of Nonradiating Vertebrogenic Pain: A Systematic Review (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10075185/). Cureus. 2023 Apr 4;15(4):e37114. Accessed 11/6/2023.
- Schnapp W, Martiatu K, Delcroix GJ. Basivertebral nerve ablation for the treatment of chronic low back pain in a community practice setting: 6 Months follow-up (https://pubmed.ncbi.nlm.nih.gov/36926532/). N Am Spine Soc J. 2023 Jan 29;14:100201. Accessed 11/6/2023.
- Tieppo Francio V, Sayed D. Basivertebral Nerve Ablation (https://www.ncbi.nlm.nih.gov/books/NBK572127/). 2023 May 22. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan. Accessed 11/6/2023.
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