Can Intracept ablation relieve my chronic low back pain?

Am I a candidate for Intracept?

If you have experienced lower back pain for six months or longer and physical therapy has not helped, you may be a candidate for Intracept basivertebral nerve ablation. This is especially true if you have been told no one knows what is causing your back pain. It’s also a likely cause if you’ve been told you pain is due to a disc problem but it hasn’t gotten better with treatment like physical therapy.

Vertebral endplate nerve dysfunction is sometimes missed or misdiagnosed and often is not found until a spine surgeon who specializes in this problem diagnoses it. The condition can be seen on an MRI, but physicians can overlook it because this type of nerve dysfunction isn’t widely recognized.

If you have low back pain and you answer yes to the following three questions, you should be assessed to know whether you have vertebral endplate nerve dysfunction, which can be treated with Intracept. You should be assessed if you:

1. Have had chronic low back pain for six months or longer.
2. Have tried conservative treatment (medication, physical therapy, etc.) for at least six months and either didn’t get relief or the relief didn’t last.
3. Have been told your lower back pain is being caused by a disc problem or an unknown cause.

How do I know if Intracept is the right treatment for my low back pain?

Having the right diagnosis to your lower back pain is the key to effective treatment. At Neurosurgery One, we screen for all conditions – including vertebral endplate nerve dysfunction – to find the cause of your low back pain. If you are diagnosed with vertebrogenic pain syndrome and have not tried nonsurgical treatments, such as medication or physical therapy, we will recommend starting there because many types of low back pain can be effectively treated without any medical intervention.

Once you have tried conservative therapy for at least six months without success – even if done through another healthcare provider – we will discuss Intracept therapy with you.

How is Intracept basivertebral nerve ablation done?

Intracept basivertebral nerve ablation is a minimally invasive, implant-free procedure. A Neurosurgery One spine surgeon will first sedate you. Next, the surgeon will access the target area through two 1-centimeter incisions in the back. The spine surgeon then positions a heat probe on the targeted nerve and uses radiofrequency energy to destroy the nerve ending. The energy destroys only a tiny portion of the nerve that transmits pain signals to the brain.

At Neurosurgery One, we conduct this procedure at an outpatient surgery center or in the outpatient surgery department of the hospital. The procedure takes about 60 to 90 minutes, with patients at the surgery center for about three-four hours from check-in to discharge.

What is recovery like?

Patients are able to return home about three to four hours after they have the Intracept procedure. Most patients will experience immediate relief from their lower back pain. Some patients, however, may initially experience increased pain due to the procedure for about one to two weeks. You should take it easy the day of the procedure. You usually can return to work and regular activity as soon as the day after having Intracept.

What are the benefits of Intracept?

The basivertebral nerve is unique because it does not regenerate like other nerves in the body. Because it cannot regrow and begin transmitting pain signals again, there should be no need to repeat the Intracept procedure. A majority of patients reported 75% to 100% pain reduction at five years after the Intracept procedure, according to Relievant Medsystems, the maker of Intracept.

Studies done on the Intracept procedure found:

• The majority of patients experienced pain relief within the first 6 weeks posttreatment¹
• Improvement in pain and function sustained for more than five years²
• Nearly 8 out of 10 patients indicated they would have the Intracept Procedure again for the same condition³
• 73% decrease in the number of patients taking opioids five years after Intracept treatment³
• 93% decrease in the number of patients receiving injections five years after Intracept treatment³

The risks associated with basivertebral nerve ablation include temporary leg pain and pain at the treatment site. Severe risks, such as nerve injury and fracture, are rare.

1. Fischgrund JS, Rhyne A, Franke J, Sasso R, Kitchel S, Bae H, et al. Intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: a prospective randomized double-blind sham-controlled multi-center study. Eur Spine J. 2018;27(5):1146-56.
2. Khalil J, Smuck M, Koreckij T, et al. A Prospective, Randomized, Multi-Center Study of Intraosseous Basivertebral Nerve Ablation for the Treatment of Chronic Low Back Pain, The Spine Journal (2019).
3. Fischgrund JS, Rhyne A, Macadaeg K, Moore G, Kamrava E, Yeung C, et al. Long-term outcomes following intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: 5-year treatment arm results from a prospective randomized double-blind sham-controlled multi-center study. Eur Spine J. epub May 25, 2020.

What other pain relief procedures are available to treat lower back pain?

If you have chronic lower back pain that isn’t vertebrogenic in nature but hasn’t gotten better with conservative treatments, such as physical therapy, there are other procedures that can help relieve pain. Neurosurgery One offers other interventional pain relief procedures for lower back pain, including spinal cord stimulation,  epidural spinal injections and radiofrequency ablation.

How can I find out if I am a candidate for Intracept in Denver?

If you live in the Denver area and would like to find out if you are a candidate for the Intracept procedure, we currently provide assessments in our Lone Tree, Castle Rock, Parker and Lakewood clinics. We also can review your MRI and discuss the findings and treatment options with you via telehealth if you are a Colorado resident.

Request an appointment online and our schedulers will call you within 3 days to schedule your appointment. Or call 720-638-7500 to schedule an assessment. We usually can see patients for an assessment within 10 days, with tele-consults even sooner.