Intracept® for Chronic Low Back Pain
Chronic low back pain is a problem that many Americans face. Upwards of 30 million people in America have chronic low back pain.
The Intracept® Procedure is focused on a particular subset of patients with lower back pain who don’t have a spinal instability or scoliosis, but they do have these changes present on an MRI, called modic changes. Research indicates that it’s actually the vertebral body itself being a pain generator, and the Intracept® Procedure then treats that painful vertebral body.
For chronic low back pain, outside the setting of a patient that has a scoliosis or 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 then potentially find improvement with lumbar fusion surgery. And lumbar fusion surgery, in the setting of no instability and no scoliosis, is very unpredictable. And so, what this procedure has done is fill a very large void in treatment for patients that have chronic low back pain.
The Intracept® Procedure involves burning the basivertebral nerve (or what we term ablating the basivertebral nerve), which is responsible for applying innervation to the bony end plates of the vertebral body (both the superior and inferior end plate). It is accomplished very minimally invasively in that the skin incision is 5-6 millimeters, just large enough to fit what’s basically a metal straw into the vertebral body, and burning that nerve before it has a chance to branch to those end plates – and therefore decreasing the pain signals coming from those degenerative or inflammatory end plates.
As a spine surgeon, this is an exciting intervention in that there’s such a large population of people that were presenting to my office with lower back pain who had tried a plethora of other treatments, thinking that now surgery must be the answer. Intracept® offers me a new tool in my armamentarium to try to relieve people of chronic lower back pain.
The Intracept® Procedure is an outpatient procedure. It’s minimally invasive, so the recovery is not more than a couple of days, just to recover from the very small skin incisions. There are no restrictions placed on patients afterwards, and in many instances the pain relief is almost immediate.
Generally, patients have been overwhelmingly positive about the procedure. We’ll call patients 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, so it’s been overwhelmingly positive.