Back pain relief in a day

When Rick Krump retired in April, he experienced more gloom than happiness — and not from having more time on his hands. In 2022, Krump had spent 27 days in the hospital after complications from prior hernia surgery. Ever since, low back pain had clouded his life.

“I’m generally an optimistic person, but I was really struggling with depression, as I was in constant pain,” he says. “I had minor back pain before that, but being in a hospital bed for weeks exacerbated my pain.”

Krump relied on opioids when physical therapy and injections didn’t help. Then his physician mentioned a procedure called Intracept. This minimally invasive procedure uses radiofrequency heat to destroy (or ablate) the nerves in the spine that are causing the pain.

The procedure treats a condition called vertebral endplate nerve dysfunction, or vertebrogenic pain. This little-known condition arises when the nerves in cartilage between the disc and the vertebrae become compressed or inflamed due to aging or injury. It can cause significant chronic lower back pain and is often mistaken for degenerative disc disease or goes undiagnosed in patients who are told they have nonspecific back pain.

Basivertebral nerve ablation, known by the brand name of Intracept, is a minimally invasive procedure that destroys the tip of the nerve to stop it from sending pain signals to the brain.

“There are many reasons for chronic lower back pain,” says Beth Gibbons, MD, FAANS, a board-certified neurosurgeon for Neurosurgery One — Castle Rock, an affiliate of AdventHealth. “Many patients who haven’t found pain relief may have vertebrogenic pain and not know it. Basivertebral nerve ablation offers a safe, effective treatment option.”

Easy Identification

Although vertebral endplate nerve dysfunction is often overlooked, it is easy to spot, Dr. Gibbons says. A physician can diagnose the condition by looking for specific changes in the endplates on an MRI. These changes, called Type 1 and Type 2 Modic changes, show inflamed bone marrow or bone marrow that has turned into fatty tissue due to decreased blood flow.

In Krump’s case, Dr. Gibbons reviewed his MRI and identified Type 1 Modic changes.

“These Modic changes were clear indications that Rick was experiencing vertebral endplate nerve dysfunction,” Dr. Gibbons says. “Patients with vertebral endplate nerve dysfunction don’t find relief with conservative treatments.”

Dr. Gibbons performed basivertebral nerve ablation as an outpatient procedure on Krump at AdventHealth Castle Rock in June. With Krump asleep under general anesthesia, Dr. Gibbons made two small incisions in his back to reach the inflamed endplates and then used radiofrequency heat to destroy the basivertebral nerves in the endplates causing the pain.

“I immediately experienced pain relief after the procedure and feel much better,” Krump says. “It wasn’t invasive, and I am very pleased with everything.”

The Candidates

Patients must meet the following criteria:

• Have chronic lower back pain lasting longer than six6 months
• Haven’t found relief with conservative treatments
• Have Type 1 or Type 2 Modic changes evident on an MRI
• Do not have severe osteoporosis

The Benefits

After basivertebral nerve ablation, most patients resume their normal activities within 1-2 days and experience pain relief within two weeks, which continues to improve for three months after the procedure. In a 2020 study, patients reported the following benefits five years after the procedure:

• 66% of patients experienced greater than 50% reduction in pain, with 34% reporting complete pain relief
• 73% decrease in the number of patients taking opioids
• 93% decrease in the number of patients receiving injections

Call Call720-638-7500, option 4, to schedule an appointment.