Basivertebral Nerve Ablation (Intracept) in Chicago
Basivertebral nerve ablation, also called Intracept, uses radiofrequency energy to quiet the basivertebral nerve, a sensory nerve inside the vertebral body, to treat vertebrogenic low back pain. During the procedure, Dr. Nidal Elbaridi uses live X-ray guidance (fluoroscopy) to place specialized instruments into the affected vertebra and reach the basivertebral nerve. Intracept is one of the radiofrequency ablation (RFA) procedures Dr. Elbaridi performs for vertebrogenic low back pain.
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Workers’ Comp, HMO referral or complex insurance? Call (312) 414-1088.
Where it’s done
Intracept is performed at Insight Hospital and Medical Center, 2525 S. Michigan Avenue, Chicago, IL 60616, and at affiliated outpatient surgery centers. Your consultation and follow-up visits are at our South Loop or Streeterville office.
What is vertebrogenic low back pain?
Vertebrogenic low back pain is pain that comes from inside the vertebral body, the main block of bone in each vertebra of the spine. The basivertebral nerve runs inside the vertebral body and carries that pain signal.
The pain comes from damage or inflammation in the vertebral endplates, the structures that connect the spinal discs to the vertebral bones. The basivertebral nerve can become chronically irritated and keep sending pain signals even after other treatments have failed.
Vertebrogenic pain is different from facet joint pain because it comes from inside the vertebral body rather than from the small joints in the back of the spine. Facet joint pain is carried by the medial branch nerves and is treated with medial branch radiofrequency ablation. Pain from inside the vertebral body is carried by the basivertebral nerve, and basivertebral nerve ablation is the procedure that treats it.
How patients describe it
- a deep, aching pain in the center of the low back
- pain that is worse with sitting, bending forward, or getting up from a chair
- stiffness and soreness first thing in the morning
- pain that stays in the low back rather than traveling down the leg, unlike sciatica
- pain that has lasted six months or longer despite physical therapy, medications, injections or other conservative treatment
Basivertebral nerve ablation is also different from vertebroplasty and kyphoplasty, which treat a fractured vertebra. It uses a similar approach to reach the inside of the vertebral body, but it treats the nerve, not a fracture.
Talk to Dr. Elbaridi about basivertebral nerve ablation
Same-week appointments at our South Loop and Streeterville offices.
Opens our secure booking calendar — this page stays open.
Workers’ Comp, HMO referral or complex insurance? Call (312) 414-1088.
How basivertebral nerve ablation works
- The basivertebral nerve sits inside the vertebral body, so Dr. Nidal Elbaridi uses a vertebroplasty-style approach to place specialized instruments into the vertebra and reach the nerve.
- Needle placement is guided by fluoroscopy, a live X-ray. Fluoroscopy guides the treatment; it does not treat.
- Radiofrequency energy then quiets the basivertebral nerve, so it stops carrying the pain signal from the vertebral body.
- Most patients have one to four vertebral levels treated in a single procedure, depending on how many painful vertebral endplates show on the MRI and in the clinical evaluation.
Every procedure is performed under fluoroscopy or ultrasound guidance.
Only sensory nerves are treated
RFA is performed only on sensory nerves, the nerves that carry pain. It is not performed on motor nerves, the nerves that move your muscles. The basivertebral nerve is a sensory nerve.
No steroids
Basivertebral nerve ablation uses no steroids. That makes it a strong option for patients who should limit steroid exposure, such as people with diabetes or obesity, and patients who would otherwise need repeated steroid injections.
Who is a candidate
Dr. Elbaridi decides whether basivertebral nerve ablation fits your pain after your consultation, your exam and your imaging. You may be a candidate if you have:
- chronic low back pain lasting six months or longer
- pain that hasn’t improved enough with conservative treatment, such as physical therapy, a home exercise program, medications, chiropractic care or spinal injections
- MRI findings of Modic Type 1 or Type 2 changes (vertebral endplate changes) at one or more lumbar levels
- pain mainly in the lower back, rather than pain caused by nerve compression, instability, fracture, infection or another spinal condition that needs a different treatment
Unlike medial branch radiofrequency ablation for facet pain, Intracept doesn’t usually require a diagnostic nerve block first. Candidates are identified from their symptoms, treatment history, physical exam and MRI. Characteristic Modic changes on the MRI are one of the key factors.
Who is not a candidate
Basivertebral nerve ablation may not be appropriate when:
- there is an active infection
- bleeding risk is not adequately controlled
- an implanted pacemaker or defibrillator has not been evaluated for the procedure
- MRI findings or symptoms point to another cause of back pain that a different procedure would treat better
- you decide not to go ahead with treatment
Intracept is designed for vertebrogenic low back pain with Modic Type 1 or Type 2 endplate changes. It may not fit if you have:
- no Modic Type 1 or Type 2 changes on a lumbar MRI
- pain mainly from a herniated disc, spinal nerve compression or significant sciatica
- severe spinal stenosis causing neurogenic claudication or leg-dominant symptoms
- significant spinal instability, such as spondylolisthesis
- a vertebral fracture, tumor, active infection or other structural spinal disease
- back pain that hasn’t lasted long enough to be considered chronic
- symptoms better explained by the sacroiliac joint, the facet joints, the hip or another pain source
Your comfort during the procedure
Anesthesia
- Unlike many outpatient radiofrequency ablation procedures, Intracept is commonly performed with monitored anesthesia care (MAC) or deeper IV sedation.
- The procedure is done inside the vertebral body and takes longer than facet joint RFA, so many patients benefit from more sedation than is typically used for medial branch nerve ablation.
- The exact anesthesia plan depends on you, the number of levels treated, and the facility.
How long it takes
- The procedure itself typically takes about 60 to 90 minutes, depending on the number of vertebral levels treated.
- Plan on about 3 to 4 hours in total at the hospital or surgery center, for check-in, preparation, the procedure, recovery and discharge.
- Because sedation is commonly used, arrange for someone to drive you home, and don’t drive for the rest of the day.
Image-guided needle placement
- Spine nerves (medial branch, basivertebral): guided by fluoroscopy, a live X-ray.
- Fluoroscopy shows the vertebra in real time, so the approach into the vertebral body can be followed as it happens.
Recovery, relief and what comes next
Recovery
Most patients go home the same day and are encouraged to walk and do light daily activities as tolerated. Many resume light activities within 24 to 48 hours.
Return to work depends on your job. Patients with desk-based jobs often return within a few days; physically demanding jobs may need more recovery time.
Relief is not always immediate. Some patients notice improvement within a few weeks, while others improve gradually over 2 to 12 weeks.
How long relief lasts
Clinical studies have shown that pain relief and functional improvement from Intracept can remain durable for multiple years in appropriately selected patients with vertebrogenic low back pain. Because it treats the basivertebral nerve inside the vertebral body, it is intended to provide long-lasting relief rather than temporary symptom control. Individual results vary with the severity of degeneration, overall spine health and other sources of pain.
Repeat procedures are uncommon. Intracept is generally intended as a one-time treatment at the treated vertebral levels. If pain returns, Dr. Elbaridi will check whether it is coming from the same levels or from another spinal condition before recommending more treatment.
A bridge to recovery, not a lifelong treatment
We believe movement is the essence of recovery: physical therapy, yoga and strengthening. Pain management is an important intermediate step. It brings pain down enough for you to do the work that keeps you better.
When appropriate, treating the source of the pain is often a better strategy than relying on long-term opioids.
An interdisciplinary plan
Dr. Elbaridi performs the full spectrum of interventional pain management, from diagnostic nerve blocks and radiofrequency ablation to minimally invasive spine procedures and implanted devices. Every plan is interdisciplinary: physical therapy, movement and strengthening, coordinated with your primary care doctor and, when needed, a spine surgeon.
Dr. Nidal Elbaridi, MD
- Anesthesiologist and interventional pain physician
- Interventional pain fellowship, Harvard Medical School / Brigham and Women’s Hospital (2016)
- Anesthesiology residency, John H. Stroger Jr. Hospital of Cook County (2015)
- MD, Ross University School of Medicine (2010)
- Former licensed physical therapist (B.S., Indiana University, 1997)
Insurance and prior authorization
- We pre-authorize every procedure, basivertebral nerve ablation included, before it is scheduled.
- We do not charge out-of-network rates. We verify benefits and pre-authorize before your procedure, so there are no surprise bills afterward.
Most insurance accepted, including Medicare, Medicare Advantage, PPO and HMO plans. Coverage depends on medical necessity — we verify before your visit.
Back pain after a work injury or accident
Your first visit can happen this week. Procedures are pre-authorized with the carrier before they’re scheduled.
We also accept Workers’ Compensation and Personal Injury (Letter of Protection) cases. See Workers’ Comp and personal injury, or call (312) 414-1088.
Basivertebral nerve ablation questions, answered
Is basivertebral nerve ablation the same as RFA?
It is one kind of nerve radiofrequency ablation. Like other nerve RFA, it uses radiofrequency energy to quiet a sensory nerve that carries pain. The difference is where the nerve is: the basivertebral nerve is inside the vertebral body, so Dr. Elbaridi reaches it through a vertebroplasty-style approach, guided by fluoroscopy.
Does basivertebral nerve ablation hurt?
Most patients feel little to no discomfort during the procedure because of the sedation used, and many have little or no memory of it afterward. Mild soreness at the treatment site or temporary low back discomfort for several days is common afterward, and usually settles with routine post-procedure care.
Is a diagnostic nerve block required before Intracept?
No. Candidates are generally identified from their symptoms, treatment history, physical exam and MRI findings rather than a diagnostic nerve block. Characteristic Modic changes on the MRI are one of the key factors.
Am I a candidate for Intracept?
You may be a candidate if you have had chronic low back pain for at least six months, have tried conservative treatment without lasting relief, and your lumbar MRI shows Modic Type 1 or Type 2 vertebral endplate changes. Dr. Elbaridi reviews your symptoms, imaging and prior treatment to decide whether vertebrogenic pain is the source and whether Intracept fits.
Is basivertebral nerve ablation covered by insurance?
Coverage depends on medical necessity, and we verify before your visit. We pre-authorize every procedure and do not charge out-of-network rates. We verify benefits and pre-authorize before your procedure, so there are no surprise bills afterward.
How long does relief last?
Many patients experience relief for several years. Repeat procedures are uncommon. We encourage physical therapy, strengthening and regular exercise to help maintain function and support long-term results.
Book your appointment at Loop Medical Center
Same-week appointments at our South Loop and Streeterville locations.
Opens our secure booking calendar — this page stays open.
Workers’ Comp, HMO referral or complex insurance? Call (312) 414-1088.