In the United States at any given time, millions of people are suffering from chronic low back pain. Debilitating low back pain affects 30-40% of the population and is responsible for 52 million medical visits.
Traditionally, chronic low back pain patients are treated with conservative modalities such as physical therapy, medications, injections, or surgical options such as spinal fusion or artificial disc replacement. Practically speaking, most patients do not receive adequate improvement from conservative treatments and only a small percentage are candidates for surgical therapies.
For many decades, the primary focus among physicians treating low back pain has been on the intervertebral disc. This has been termed “discogenic pain”. However, scientific research over the last few years has shown that vertebral endplates are a significant source of chronic low back pain.
MRI scanning of the lumbar spine are useful in revealing inflammation, edema, vertebral endplate changes, disruption and fissuring of the endplate, and fibrous tissue within adjacent bone marrow.
Such changes are characterized by hypotensive signals and changes to the vertebral body marrow (Type I Modic changes), and hyperintensive signals, indicating replacement of normal bone marrow by fat (Modic Type II changes).
Many patients with this condition of severe, advanced degenerative disc disease often experience unremitting central low back pain without leg symptoms. This pain is exacerbated by all physical activity , and results in a severe impairment of a patient’s quality of life.
Most often, doctors treat such conditions with pain medicine (opioids) , which may provide short-term improvement but pose risks such as decreased immunity, somnolence, respiratory depression, dependence , addiction and opioid induced hyperalgesia. When patients fail to improve, they are referred to a surgeon for fusion surgery. Unfortunately, lumbar fusion surgery, in the setting of no instability and no scoliosis, is very unpredictable.
Intracept is an outpatient procedure that has filled a large void in treatment options for patients suffering from chronic low back pain.
Research has shown that pain from the diseased vertebral endplates is transmitted via the basivertebral nerve, which is found within the vertebral body. The Intracept procedure developed by Relievant, is commercially available in the U.S, and is supported by level 1 randomized controlled trials as well as long-term durability data showing improvement in pain and physical function maintained beyond 5 years.
The procedure is performed through a small incision through which a specialized Intracept probe is placed into the anterior portion of the vertebral body. Once the probe is positioned at the precise location of the basivertebral nerve, radiofrequency ablation is used to disable the nerve. This process blocks the pain signal before it has a chance to branch out to the endplates.
Since the basivertebral nerve is an unmyelinated nerve, this procedure does not have to be repeated yearly, unlike the common lumbar ablation. As stated above, multi-center research studies reveal maintenance of pain relief beyond five years.
The Intracept procedure therefore, is a minimally invasive, outpatient option for patients who have not responded to conservative therapy. It is implant- free and preserves the structure of the spine. It provides durable relief of chronic vertebrogenic low back pain by targeting the basivertebral nerve.
This outpatient procedure is often completed in 30-45 minutes and no restrictions are placed on patients afterward. In many patients, the pain relief is almost immediate.
Contact Florida Pain Center of Naples today for more information and to schedule your next appointment at 239-659-6400.
Florida Pain Center of Naples
730 Goodlette Rd North, #200, Naples, FL 34102