From the Guidelines
The Intracept procedure is a recommended treatment option for patients with chronic low back pain caused by vertebrogenic pain from the basivertebral nerve, as it has been shown to provide significant pain reduction lasting at least 5 years in many patients. The procedure involves using radiofrequency ablation to target and destroy the basivertebral nerve within the vertebral body, which carries pain signals from damaged vertebral endplates to the brain 1. The Intracept procedure is generally recommended for patients who have had chronic low back pain for at least six months, have not responded to conservative treatments like physical therapy or medication, and have evidence of vertebral endplate changes (Modic changes) on MRI.
Some key points to consider when evaluating the Intracept procedure include:
- The procedure typically takes 60-90 minutes under conscious sedation, with patients often going home the same day
- A small incision is made, and a specialized probe is guided through the pedicle of the vertebra to the basivertebral nerve, where heat is applied to ablate the nerve
- Recovery is relatively quick, with most patients returning to normal activities within days to weeks
- The procedure works by interrupting the pain pathway, preventing pain signals from reaching the brain
- Clinical studies have shown significant pain reduction lasting at least 5 years in many patients, although the evidence is not universally accepted, with some reviews finding inconsistent conclusions 1.
It is essential to note that the supporting evidence for interventional procedures, including the Intracept procedure, is uncertain, and positive results are more likely when the review is authored by an interventionalist versus a non-interventionalist 1. However, based on the available evidence, the Intracept procedure is a viable option for patients with chronic low back pain who have not responded to conservative treatments.
From the Research
Intracept Procedure Overview
- The Intracept procedure is a minimally invasive treatment for chronic low back pain, specifically targeting the basivertebral nerve [ 2 ].
- This procedure has shown promise in reducing chronic low back pain in patients with Modic changes [ 3 ].
Efficacy and Safety
- Studies have demonstrated the efficacy and safety of basivertebral nerve ablation in treating chronic low back pain [ 3,4 ].
- The procedure has been shown to result in statistically significant improvements in pain and disability scores, including the Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) [ 3 ].
Procedural Technique
- The Intracept procedure involves radiofrequency ablation of the basivertebral nerve, which can be performed in a community practice setting [ 3,5 ].
- The procedure requires careful patient positioning and setup, as well as step-by-step instructions for the ablation process [ 5 ].
Current Research and Future Directions
- Current research suggests that basivertebral nerve ablation may be a promising treatment for chronic low back pain, particularly in patients with Modic changes [ 4,6 ].
- However, further studies are needed to fully understand the efficacy and safety of this procedure, as well as to address current knowledge gaps and limitations [ 4,6 ].