UC San Diego Health is now offering a new minimally invasive approach to provide relief for patients suffering from chronic low back pain (CLBP). The new treatment is called “Intracept”— an outpatient procedure that targets nerves located in the vertebrae or bones of the spine. UC San Diego Health is the first hospital system in the region to offer the procedure.
Low back pain is a leading cause of chronic pain and disability worldwide, with an estimated 80 percent of people likely to experience it at some point in their lives. Approximately 40 percent of back pain cases are linked to abnormalities of spinal discs and adjacent vertebrae.
“Our understanding of how degenerative changes in the disc and the adjacent vertebral structures can lead to pain and dysfunction has evolved significantly, leading to more accurate diagnoses, wider selection of treatment options and better long-term outcomes,” said Farshad Ahadian, MD, medical director of the Center for Pain Medicine at UC San Diego Health.
“In many cases, pain transmitted through the basivertebral nerves can be a source of CLBP. Intracept is designed to provide durable pain relief without an implant. Like any therapy, this is not a panacea for all types of back pain and careful assessment and patient selection are key to success. But for the appropriate candidate, basivertebral nerve ablation is a game changer.”
During the 60- to 90-minute procedure, a specialized probe is advanced into the vertebrae under fluoroscopic guidance and uses radiofrequency energy (heat) to disable the nerve, rendering it unable to transmit pain signals. The procedure does not change the structure of the spine.
The technique is supported by data from two randomized control trials involving more than 350 participants enrolling in the trials, said Ahadian, a board-certified anesthesiologist who specializes in pain management.
One trial demonstrated a highly significant difference in pain reduction at three months for patients who received the procedure compared to patients who received standard (conservative) care. In the other trial, patients who received the Intracept Procedure reported a 53 percent decrease in pain at their two-year follow-up appointments.
Long-term outcomes post-basivertebral nerve ablation, with an average 5-year follow-up, were published in May 2020. The results found persistent improvement of pain and function over time.
Ahadian said the procedure is best suited for patients who have experienced chronic low back pain for at least six months and who have not responded to at least six months of conservative care, defined as employing non-surgical treatment options like physical therapy, medication and injections.
UC San Diego Health’s Center for Pain Medicine focuses on reducing and eliminating suffering and improving function in individuals with lower back pain or other pain related to the spine, joints, muscle-skeleton, post-surgery complications, physical injury, nerve damage, psychological factors and metabolic problems, such as diabetes.
It was named a Clinical Center of Excellence in Pain Management in 2010 and 2014 by the American Pain Society, recognizing its “outstanding exemplary care."
Ahadian’s expertise covers minimally invasive treatments for neurogenic claudication from lumbar spinal stenosis and lumbar vertebrogenic/discogenic pain; neurostimulation interventional therapies for the head and neck region; spinal diagnostics and therapeutics; diagnostic and therapeutic interventions for joint pain; integrative medicine and medical acupuncture.
To learn more about treatment of back pain at UC San Diego Health, visit health.ucsd.edu.