Frequently Asked Questions

What is basivertebral nerve ablation?

Basivertebral nerve ablation (BVNA) is a minimally invasive procedure that targets the basivertebral nerve inside the vertebral body. By using radiofrequency energy, the nerve is ablated (deactivated) to relieve chronic vertebrogenic low back pain associated with Modic changes on MRI.

How is the Intracept procedure different from other treatments?

The Intracept procedure specifically targets vertebrogenic pain at its source by ablating the basivertebral nerve. Unlike traditional therapies that manage symptoms (e.g., physical therapy, injections), Intracept offers durable pain relief with no implants, minimal recovery, and proven long-term outcomes.

Is the procedure covered by insurance?

Yes, most major insurance providers—including Medicare—now cover basivertebral nerve ablation when performed for appropriately selected patients with imaging-confirmed Modic type 1 or 2 changes. Prior authorization may be required.

What are the risks or complications?

BVNA is considered safe and low-risk. Potential complications include temporary soreness, infection, or bleeding at the access site. Severe complications are rare, especially in experienced hands.

Are there alternative devices besides Intracept?

Yes. In addition to Intracept by Boston Scientific, Stryker’s OptaBlate and New4med’s RF system (launched in Europe) are emerging alternatives offering procedural innovations like shorter lesion times and steerable access tools.

Who is a candidate for BVNA?

Ideal candidates are adults with chronic low back pain unresponsive to conservative therapy for at least 6 months, MRI showing Modic changes, and no contraindications such as significant spinal instability or widespread disc degeneration.

More Frequently Asked Questions

What is the next step if nerve ablation doesn’t work?

If nerve ablation fails to relieve your symptoms, your provider may consider repeating the procedure, switching to a different type of ablation (e.g., cooled RF), or evaluating you for advanced interventions like spinal cord stimulation, Intracept® procedure, or minimally invasive surgery based on imaging and symptomatology.

What is the life expectancy of someone with an ablation?

Nerve ablation has no impact on life expectancy. It is a localized, outpatient procedure aimed at improving quality of life by reducing chronic pain—especially in conditions like facet-mediated or vertebrogenic pain.

What is a permanent nerve block for back pain?

“Permanent” nerve blocks generally refer to neurolytic procedures such as radiofrequency ablation. These aim to interrupt the sensory pain signals from targeted nerves. While not truly permanent, relief can last 6–24 months depending on the technique and diagnosis.

What is the next treatment when a nerve block has not worked?

If a diagnostic or therapeutic nerve block fails, your physician may reassess the diagnosis. Alternatives may include repeat block under imaging guidance, RFA, BVNA (e.g., Intracept), or referral for structural intervention if mechanical pathology is suspected.

What stops nerve pain immediately?

Immediate relief from nerve pain may be achieved with a diagnostic nerve block using local anesthetic. Oral medications like gabapentinoids or steroids may also help but typically take longer to act. Always consult a physician for appropriate evaluation and diagnosis.

How much does a permanent nerve block cost?

Costs vary by region and insurance, but in the U.S., a radiofrequency ablation can range from $1,500 to $4,000. Medicare and most private insurances cover it for appropriate indications. Be sure to verify coverage with your provider.

What is the new type of ablation?

The newest type of ablation in spinal care is basivertebral nerve ablation (BVNA), exemplified by the Intracept procedure. This FDA-cleared therapy targets pain inside the vertebral body due to Modic changes. Stryker’s OptaBlate and New4med’s platform are recent entries in this evolving space.

How long does BVN ablation last?

Clinical studies show that relief from BVNA can last at least 5 years, with some patients reporting sustained benefit beyond that. Long-term durability is one of the key strengths of the Intracept procedure.

How is Intracept different from other ablation procedures?

Unlike traditional ablation techniques that target facet or sacroiliac joints, Intracept specifically addresses vertebrogenic pain by targeting the basivertebral nerve deep within the vertebral body. It is minimally invasive, implant-free, and supported by long-term outcome data.

What is the downside of nerve ablation?

Common downsides include temporary pain flare-ups, numbness, or procedural soreness. In rare cases, nerve regeneration may lead to recurrence of symptoms. However, serious complications are uncommon when performed by experienced clinicians.

Does Medicare pay for the Intracept procedure?

Yes. As of 2023, Medicare covers the Intracept procedure for eligible patients who meet imaging and clinical criteria (e.g., Modic changes, chronic pain ≥6 months, failed conservative therapy). Pre-authorization may be needed.

Why am I in so much pain after radiofrequency ablation?

A post-procedure pain flare is not uncommon due to temporary irritation of the treated nerves. This usually resolves within 1–2 weeks. Persistent or worsening pain should prompt reevaluation to rule out incorrect target selection or overlapping pathology.