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Basivertebral Nerve Ablation

Overview

Basivertebral nerve ablation, also called the Intracept® procedure, is a minimally invasive treatment for people with vertebrogenic back pain (a specific type of chronic low back pain). 

Vertebrogenic pain occurs when there’s damage to the endplates of your vertebrae and trigger pain at the basivertebral nerve inside your vertebrae. 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.

Who is basivertebral ablation for?

To be considered for basivertebral nerve ablation you should have had chronic low back pain for over 6 months which has failed to respond to conservative treatments, such a medication, physiotherapy and injections, and have characteristic Modic type 1 and/or 2 changes on MRI, such as in this image.
Basivertebral nerve ablation is not a treatment for all types of back pain and would not be a suitable treatment for patients with spinal stenosis (narrowing of the spinal canal), radiculopathy (sciatica going down the legs), previous spinal surgery, spine infection, osteoporosis or cancer.

What happens during a basivertebral nerve ablation procedure?

This procedure is typically performed under conscious sedation or a general anaesthetic. 

You would lie face down on an examination table.

Using x-ray guidance a thin tube (cannula) would be advanced into your vertebra and small curved instruments used to create a channel to where the basivertebral nerve enters your vertebrae.

A small radiofrequency probe is then placed through the channel next to the trunk of your basivertebral nerve.

Radiofrequency heat is used to ablate (damage) the basivertebral nerve.

The instruments are then all removed.

Basivertebral nerve ablation usually takes between 60 and 90 minutes to complete. It’s an outpatient procedure and you will be able to go home once your sedation wears off.

What is the success rate of basivertebral nerve ablation?

Research suggests that basivertebral nerve ablation using the Intracept device 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.

What are the risks or complications of an Intracept procedure?

Complications are uncommon but can happen after any interventional procedure. Possible complications include:

    Bleeding.

    Infection.

    Nerve damage.

    Increased back pain.

    The team takes every precaution to reduce the risk of complications during all interventional procedures. 

    Are you a candidate for basivertebral nerve ablation?

    If you would like to learn more about basivertebral nerve ablation and discuss whether you may be a candidate for this treatment, you can arrange a clinic appointment with Dr David McKean here.

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