About Basivertebral Nerve Ablation (Intracept)
The basivertebral nerve runs inside each vertebra and carries pain signals from the endplates, the thin layers of bone at the top and bottom of each vertebra that meet the discs. When endplates are damaged or inflamed, they can cause chronic, central low back pain. This pattern is called vertebrogenic pain.
An MRI can show specific changes in the endplates, called Modic changes, that suggest this source of pain. Basivertebral nerve ablation places a small probe into the vertebra through a narrow tube and uses radiofrequency heat to quiet the nerve.
The procedure is done as an outpatient procedure in an appropriate procedure facility with X-ray guidance. It is designed for pain in the center of the low back, not for leg pain from a pinched nerve.
What happens during treatment
- 1.
Dr. Chen reviews your history and MRI to look for endplate changes at the painful levels.
- 2.
On the day of the procedure, you receive sedation and lie face down.
- 3.
Under X-ray guidance, a small tube is placed into the vertebra, and a probe heats the basivertebral nerve.
- 4.
The process is repeated at each treated level. You go home the same day with a driver.
Who may be a good candidate
- Adults with chronic low back pain lasting at least six months that has not improved with at least six months of conservative care.
- People whose MRI shows Modic type 1 or type 2 endplate changes at the painful levels.
- People whose pain is mainly in the center of the low back, often worse with sitting, bending, or activity.
Recovery
Soreness at the needle sites and a temporary increase in back pain are common early on and usually settle within two weeks. Most people return to light activity within a few days. Improvement typically develops over weeks. A progressive core and hip strengthening program helps you build on the relief.
Risks and limits
Possible risks include soreness, bleeding, infection, nerve irritation, and, rarely, fracture of the treated vertebra. The procedure does not treat pain coming from a pinched nerve, facet joints, or the sacroiliac joint, and it does not help everyone. It is not appropriate if you have an active infection, a spinal tumor, a recent vertebral fracture, or osteoporosis severe enough to weaken the vertebrae.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.
Questions about Intracept
- How do I know if I have vertebrogenic back pain?
- Vertebrogenic pain is usually central low back pain that has lasted months or years. The key clue is an MRI showing Modic type 1 or type 2 changes at the endplates, combined with symptoms that fit the pattern. Dr. Chen will review your imaging with you.
- Where is the Intracept procedure performed?
- It is an outpatient procedure performed in a sterile procedure facility with X-ray guidance and sedation. Dr. Chen will explain the location and preparation before scheduling.
- Does basivertebral nerve ablation help sciatica?
- No. It targets pain from the vertebral endplates, not leg pain from a pinched nerve. If sciatica is part of your picture, other treatments such as epidural injections and rehab may be considered.