Basivertebral Nerve Ablation (Intracept)

Not all back pain comes from discs or joints. In some people, chronic low back pain comes from the vertebral endplates, the top and bottom surfaces of the bones in the spine. Pain signals from the endplates travel through a nerve inside each vertebra called the basivertebral nerve.

Basivertebral nerve ablation, often known by the brand name Intracept, is a minimally invasive outpatient procedure that uses radiofrequency energy to turn off this nerve. It is performed by spine and pain specialists.

It may be an option for adults who have:

• Chronic low back pain for at least six months
• Not improved enough with at least six months of conservative care, such as physical therapy and medicine
• Specific changes in the vertebral endplates on MRI, called Modic changes, in the lower lumbar spine

It is not a treatment for leg pain from a pinched nerve. An MRI is needed to see whether you have the type of changes that predict a good result. See also discogenic back pain and degenerative disc disease.

• Ask about blood thinners. If you take a blood thinner such as warfarin, apixaban (Eliquis), rivaroxaban (Xarelto), clopidogrel (Plavix) or daily aspirin, tell the doctor doing the injection. Some injections require stopping it for a few days and some do not. Never stop a blood thinner on your own; the doctor who prescribes it will tell you if and when it is safe.
• You will usually not eat for several hours beforehand because sedation or anesthesia is used.
• Arrange for a driver and someone to help you that day.
• Bring your list of medicines and your MRI images and report.

The procedure is done as an outpatient with sedation or anesthesia. Through a small incision, the doctor guides a thin tube into the vertebral body using X-ray, places a probe near the basivertebral nerve and heats it with radiofrequency energy. One or two levels are commonly treated, and it usually takes about an hour.

Most people go home the same day. Soreness at the incision for a few days is common. Many people notice improvement within a few weeks, and studies have shown lasting relief for years in carefully selected patients. Unlike a fusion, it does not involve implants or change the structure of the spine.

Basivertebral nerve ablation is generally safe. Possible risks include soreness, infection, bleeding and, rarely, nerve injury. Your specialist will review the risks for your situation.

What is Intracept?

Intracept is a brand name for basivertebral nerve ablation, a minimally invasive procedure that quiets the nerve carrying pain signals from the vertebral endplates.

Who is a candidate for basivertebral nerve ablation?

Adults with chronic low back pain for at least six months that has not improved with conservative care, and specific endplate (Modic) changes on MRI.

Is basivertebral nerve ablation the same as facet ablation?

No. Facet ablation targets the nerves to the small joints on the back of the spine. Basivertebral nerve ablation targets a nerve inside the vertebral bone.

If you have neck pain, back pain or nerve pain and want to know which treatments make sense for you, call 470-293-9800 or contact us to schedule a visit with Dr. Grunch or one of her physician assistants. You can also ask general questions any time through our “Ask Us Anything” chat.

Related: All non-surgical treatment options · Discogenic back pain · Radiofrequency ablation

This information is for educational purposes only and is not medical advice. It does not replace individualized care from a licensed physician. Please talk to your provider about your symptoms and treatment options.