---
title: "Intracept Procedure"
---
## What Vertebrogenic Pain Is and Why It Often Gets Missed
Most chronic low back pain is attributed to the discs, facet joints, or muscles. But for many patients, the actual source is the vertebral endplate, the bony surface where the disc meets the vertebra. When the endplate is damaged or inflamed, signals travel through a small nerve called the basivertebral nerve, which carries pain signals from the vertebral body itself.
This source is called vertebrogenic pain. It is typically marked by chronic low back pain that worsens with bending forward, sitting for extended periods, or physical activity. Standard MRI often misses it because the diagnostic finding (Modic Type 1 or Type 2 endplate changes) requires specific interpretation.
For patients with vertebrogenic pain, traditional treatments often fail. Epidural injections target a different source, facet injections target a different structure, and disc procedures target a different problem. The Intracept Procedure is the first treatment developed specifically for this source of pain.
## How the Intracept Procedure Works
The Intracept Procedure uses radiofrequency energy to ablate the basivertebral nerve, the specific nerve carrying pain signals from the vertebral body. Once the nerve is ablated, it cannot transmit pain signals from the affected vertebra.
This is a single-treatment procedure. Unlike radiofrequency ablation of facet joint nerves, the basivertebral nerve does not regenerate in a way that requires repeat ablation, and most patients receive long-term relief from a single Intracept Procedure.
The procedure is FDA-cleared and is performed using the Intracept System, the only device approved for basivertebral nerve ablation. It typically takes about an hour and is performed in our affiliated surgery center under image guidance and propofol (IV) sedation.
## Who Is a Candidate
The Intracept Procedure is indicated for patients with:
- Chronic low back pain lasting at least six months
- Pain that has not responded adequately to at least six months of conservative treatment (physical therapy, anti-inflammatory medication, activity modification)
- MRI findings consistent with vertebrogenic pain (Modic Type 1 or Type 2 endplate changes at L3-S1)
- A pain pattern consistent with the vertebrogenic source (axial low back pain that worsens with activity, particularly bending forward and prolonged sitting)
Your physician will review your imaging and history at consultation to determine whether you fit the candidacy profile. Not every patient with chronic low back pain has vertebrogenic pain, and identifying the right patient is the most important factor in a successful Intracept outcome.
## What the Evidence Shows
The Intracept Procedure has strong clinical trial evidence. The pivotal SMART trial, a randomized controlled trial published in peer-reviewed literature, demonstrated significant pain reduction compared to sham treatment, with results sustained for years following the single procedure. Multiple long-term follow-up studies have confirmed durable benefits at five years or more.
This is meaningfully different from many interventional pain procedures, which produce months of relief and require repeat treatment. Intracept is a single procedure with multi-year benefit for appropriately selected patients.
## Why Patients Choose PHI for the Intracept Procedure
## What to Expect
## Frequently Asked Questions
**Q: Is the Intracept Procedure FDA-approved?**
The Intracept System is FDA-cleared for the treatment of chronic vertebrogenic low back pain. It is the only device approved for basivertebral nerve ablation.
**Q: How is the Intracept Procedure different from radiofrequency ablation of facet joints?**
Both use radiofrequency energy to ablate a nerve, but they target different sources of pain. Facet RFA targets the medial branch nerves carrying pain from the facet joints. Intracept targets the basivertebral nerve carrying pain from the vertebral endplate. They are complementary procedures for different conditions, and many patients have one but not the other.
**Q: How long does the relief last?**
For most patients, Intracept provides durable relief from a single procedure. Long-term follow-up studies have demonstrated sustained pain reduction at five years post-procedure for appropriately selected patients.
**Q: Will I be awake during the procedure?**
The procedure is performed under propofol (IV) sedation. You will not be fully awake, but general anesthesia is not typically required.
**Q: Will I be able to drive home?**
No. Because the procedure involves sedation, you must arrange transportation.
**Q: How do I know if I'm a candidate?**
The most important factor is your MRI findings. Patients with Modic Type 1 or Type 2 endplate changes at the L3-S1 levels, combined with chronic low back pain consistent with the vertebrogenic pattern, are typical candidates. Your physician will review your imaging and confirm whether you fit the criteria during consultation.
**Q: What are the risks?**
The Intracept Procedure has a strong safety profile. Risks include the standard surgical risks of bleeding, infection, and post-procedure pain at the access site, plus the rare but specific risks of any spinal procedure. Your physician will review the complete risk profile during consultation.
**Q: How much does the Intracept Procedure cost at PHI?**
PHI is out-of-network with all insurance plans. Pricing varies based on the number of levels treated and other procedural factors, and all costs are disclosed at consultation, with no surprise billing.
**Q: Do you accept international patients?**
Yes. PHI regularly treats patients from outside Los Angeles, including Las Vegas, Palm Springs, London, and other international locations. Intracept is particularly suited to international patients because it is a single procedure with durable benefit, eliminating the need for ongoing return visits.
> A prospective, randomized, multicenter study of intraosseous basivertebral nerve ablation for the treatment of chronic low back pain. The Spine Journal.
— [Khalil JG, et al.](https://pubmed.ncbi.nlm.nih.gov/31229663/)
> 510(k) clearance summary for the Intracept Intraosseous Nerve Ablation System (K162176). U.S. Food and Drug Administration.
— [U.S. Food and Drug Administration](https://www.accessdata.fda.gov/cdrh_docs/pdf16/K162176.pdf)
> Long-term outcomes following intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: 5-year treatment arm results from a prospective randomized double-blind sham-controlled multicenter study. European Spine Journal, 2020.
— [Fischgrund JS, et al.](https://link.springer.com/article/10.1007/s00586-020-06448-x)
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