Basivertebral nerve ablation (BVNA)—often referred to by the commercial name Intracept® procedure—is a minimally invasive treatment for chronic low back pain that originates from the vertebral endplates of the spine. It uses radiofrequency energy to burn and disable the basivertebral nerve inside the vertebral bone, stopping pain signals from damaged vertebral endplates (vertebrogenic pain) from reaching the brain, offering long-term relief for chronic low back pain without implants. The procedure involves creating a channel into the vertebra and delivering heat via a probe to ablate the nerve, leading to significant pain reduction and improved function.
What are the Indications?
BVNA is designed for people with chronic axial low back pain (>6 months) that has not improved with conservative treatments like physical therapy, medications, or injections. It specifically targets vertebrogenic pain, which is associated with: Modic type 1 or type 2 changes seen on MRI and pain coming from the vertebral body/endplates, not discs, joints, or nerves to the legs
Preparing for BVN Ablation
Prior to the procedure, you will meet with your doctor to go over all the risks and benefits of the procedure and have all your questions answered. As it is a medical procedure, your doctor may order blood tests. The doctor will order an MRI and x-rays to help determine the precise areas with damaged vertebral endplates. You should not eat or drink anything 8 hours before the surgery. You may take your medications with a sip of water unless otherwise directed by the Anesthesiology team. You may have to temporarily discontinue certain medications such as blood thinners or diabetic medication. The procedure may not be performed if you have an ongoing infection, elevated blood glucose or elevated blood pressure.
What to expect during your procedure?
You will check into the facility at your scheduled time. You will be asked to fast for 8 hours prior to your procedure. You will be brought back and prepped by a nurse on staff. They will insert the IV to be used for your anesthesia. You will meet with the anesthesiologist and your doctor prior to the procedure. Once you’re taken to the procedure room you will be put under general anesthesia and placed in the prone position and a fluoroscopy machine will be brought into position. Your doctor will then numb the area with a local anesthetic and using live fluoroscopic guidance to perform the procedure. The whole procedure typically takes an hour or less for the majority of cases.
What to expect after the procedure?
After your procedure, we will take into a recovery room; we will remove your IV, and a nurse will closely monitor you while you wake up from your anesthesia and administer medicine for pain control or to treat nausea as needed. You will be asked not to drive for at least 24 hours after the procedure, and you must have a driver to drive you home from the hospital once you’re discharged. You may feel some discomfort in the injection areas that could last a few days, but can resume normal activity almost immediately. Some patients experience pain relief immediately, but most experience progressive improvement in pain over 4-6 weeks. You will be seen in office for follow up approximately 10 days after the procedure.
What risks or complications are associated with the procedure?
As with any procedure, a BVN ablation may be associated with certain risks and complications such as pain (temporary), bruising, infection, bleeding, or reaction to anesthesia. Serious complications are uncommon and afterward you should experience considerable relief from pain and improved quality of life.
Is there anything my doctor needs to know prior to the procedure?
You should tell your doctor if you are pregnant, on blood thinners, diabetic, or if you have any other concerns you would like to address beforehand.
The above information is for general education purposes only. Please ask your doctor any specific questions you may have during your visit.
