Chronic low back pain afflicts millions of Americans and can be severely limiting in everyday activities. When patients don’t respond well to nonsurgical treatment methods for back pain, they often think spinal fusion surgery is their only remaining option. But for some, there is another type of treatment that could relieve their back pain: the Intracept® Procedure.
Intracept is indicated for patients with chronic low back pain who don’t have a spinal instability or scoliosis, but they do have changes present on an MRI, called modic changes. These patients generally have experienced chronic low back pain for more than six months and have not responded to nonsurgical treatments.
I have been performing the Intracept Procedure since 2017, when it was still in clinical trial stages. As a result of the study’s successful completion, the Intracept Procedure is now available commercially. Not surprisingly, patients and referring providers have many questions about this new treatment option. I’ve provided answers to the most commonly asked questions below:
What is the Intracept Procedure?
The Intracept® Procedure is an outpatient, minimally invasive procedure that targets the basivertebral nerve, which is located in the bones of the spine (vertebrae).
What happens during the Intracept Procedure?
To perform the procedure, I advance a specialized Intracept probe into the vertebrae through a small incision in the lower back. The incision is 5-6 millimeters, just large enough to fit what’s basically a metal straw into the vertebral body. Once the probe is positioned at the precise location of the basivertebral nerve, it uses radiofrequency energy (heat) to disable the nerve, a process known as basivertebral nerve ablation.
How does Intracept help relieve chronic low back pain?
The pain-sensing basivertebral nerve is responsible for applying innervation to the bony end plates of the vertebral body (both the superior and inferior end plate). When the Intracept probe burns that nerve, it blocks the pain signals before they have a chance to branch to those end plates.
Watch this video to learn more about how the Intracept Procedure works:
How is Intracept different from other treatments for chronic low back pain?
Outside the setting of a patient that has scoliosis or a lumbar instability, treatments in the past have revolved around physical therapy and/or plus-minus epidural steroid injections. We used to think that patients who failed those treatments would potentially find improvement with lumbar fusion surgery. And lumbar fusion surgery, in the setting of no instability and no scoliosis, is very unpredictable. So this procedure has filled a very large void in treatment for patients that have chronic low back pain.
Additionally, even though this procedure involves radiofrequency energy to ablate the nerve, it is different from other procedures that use similar approaches – namely, radiofrequency annuloplasty (RFA) and intradiscal electrothermal therapy (IDET). RFA and IDET are used to treat back pain stemming from tears or ruptures in the annulus, which is the connective tissue between vertebrae. Intracept, on the other hand, addresses modic changes that stem from degeneration rather than a tear or rupture.
What are the key benefits of the Intracept Procedure?
Intracept® is a minimally invasive, outpatient procedure, so the recovery period is rapid – often not more than a couple of days. It is implant-free and preserves the structure of the spine. There are no restrictions placed on patients afterward, and in many instances the pain relief is almost immediate.
For a first-hand patient perspective on the Intracept experience, watch this video:
What response have you seen to the Intracept Procedure?
Generally, patients have been overwhelmingly positive about the procedure. We’ll call them the next day, and on a few phone calls, we’ve had people out walking the dog saying they feel better now than they have in years.
About the Author
Theodore Koreckij, M.D. is a board-certified and fellowship-trained orthopedic surgeon specializing in conditions of the spine, including adult degenerative disorders and conditions associated with metastatic disease.
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