Basivertebral Nerve Ablation – FDA Cleared Intracept® Procedure
Told There’s Nothing Left to Try for Your Back Pain? There Might Be One More Answer.
Chronic low back pain doesn’t always come from a disc or a pinched nerve — sometimes it comes from inside the bone itself. Basivertebral nerve ablation (the Intracept® Procedure) targets that source directly, offering durable relief without implants or spine surgery.
Dual board-certified physician · NYU & Weill Cornell-trained · Same-day appointments available · FDA-cleared, minimally invasive procedure
Meet Dr. Matthew Spiegel
Matthew A. Spiegel, MD is the founder and medical director of UES Interventional Pain and a dual board-certified specialist in Interventional Pain Management and Anesthesiology. He trained at NYU Grossman School of Medicine, completed his anesthesiology residency across NewYork-Presbyterian/Weill Cornell, Memorial Sloan Kettering, and Hospital for Special Surgery, and finished an ACGME interventional pain fellowship at Northwell Health.
Recognized as a Super Doctors® Rising Star and the author of 15+ peer-reviewed publications on spine and pain management, Dr. Spiegel holds hospital affiliations with NYU Langone, Northwell Lenox Hill, and Hudson Regional Hospital. His approach to procedures like basivertebral nerve ablation starts with getting the diagnosis right: this treatment works well for the right patient and poorly for the wrong one, so a careful MRI review and clinical evaluation come before any recommendation — not after.
Does This Sound Like Your Back Pain?
Vertebrogenic pain — the kind basivertebral nerve ablation treats — has a fairly specific pattern. See how many of these apply to you:
- Deep, aching pain centered in the lower back, not down the legs
- Worse with sitting, bending forward, or standing for long periods
- Pain that has lasted 6 months or longer
- Little improvement from physical therapy, medication, or injections
- MRI report mentions “endplate changes” or “Modic changes”
If two or more sound familiar, it’s worth finding out whether vertebrogenic pain is the cause.
What Basivertebral Nerve Ablation Treats
Chronic Axial Low Back Pain
BVN ablation is indicated for chronic axial low back pain — pain centered in the lower back that isn’t primarily radiating down the legs.
Vertebrogenic Pain
This procedure specifically treats vertebrogenic pain, a distinct type of back pain caused by degenerative changes in the vertebral endplates. These changes often show up on MRI as Modic type 1 or type 2 changes and are commonly overlooked as a pain generator.
Vertebrogenic pain is typically:
- Mechanical and persistent
- Worse with sitting, bending, or prolonged standing
- Frequently unresponsive to injections, medication, or physical therapy alone
How the Intracept® Procedure Works
1.Precise Access
Through a small incision in the lower back, a thin cannula is guided into the affected vertebra using fluoroscopic imaging.
2.Targeted Ablation
A specialized radiofrequency probe is advanced through the cannula to reach the basivertebral nerve, which runs within the vertebral body and transmits pain signals from the endplates.
3.Pain Signal Interruption
Controlled radiofrequency energy heats and ablates the nerve, permanently stopping it from sending pain signals to the brain — without affecting spinal stability or surrounding structures.
Key Benefits
Minimally Invasive
- Small incision
- No implants or hardware
- Preserves normal spinal anatomy
Long-Lasting Pain Relief
Because the basivertebral nerve does not regenerate, many patients experience sustained pain relief lasting years, rather than temporary symptom control.
Improved Function and Quality of Life
Clinical studies show meaningful improvements in:
- Daily activity tolerance
- Sitting and standing endurance
- Overall physical function
- Reduced reliance on pain medications
What to Expect
During the Procedure
- Performed under anesthesia for comfort
- Typically completed in under an hour
- Same-day discharge in most cases
After the Procedure
- Mild soreness or stiffness is common for several weeks
- Pain relief develops gradually as inflammation resolves
- Most patients notice significant improvement over 3 to 6 months
Unlike steroid injections, this is not a temporary numbing effect — it’s a structural interruption of pain transmission.
Who Is a Good Candidate?
You may be a candidate for basivertebral nerve ablation if you:
- Have chronic low back pain lasting 6 months or longer
- Have pain primarily localized to the lower back (not leg-dominant)
- Show vertebral endplate changes on MRI
- Have not achieved adequate relief with conservative care such as physical therapy, medication, activity modification, or injections
A thorough evaluation, including imaging review and clinical correlation, is essential to determine whether your pain is truly vertebrogenic.
Why Careful Evaluation Matters
Basivertebral nerve ablation is highly effective for the right diagnosis — and unlikely to help if the pain source is muscular, facet-related, sacroiliac, or nerve-root driven. At UES Interventional Pain, patient selection is deliberate and evidence-based: the goal isn’t to offer advanced procedures for their own sake, but to apply them only when the anatomy, imaging, and symptoms align.
If you have persistent low back pain and have been told that “nothing else can be done,” basivertebral nerve ablation may offer a path forward. A consultation can determine whether vertebrogenic pain is contributing to your symptoms — and whether the Intracept® Procedure is an appropriate option for you.
Frequently Asked Questions
What is basivertebral nerve ablation?
A minimally invasive procedure that treats chronic low back pain caused by damaged vertebral endplates. It uses radiofrequency energy to ablate the basivertebral nerve, which carries pain signals from the vertebral body to the brain.
What is vertebrogenic low back pain?
A specific type of chronic low back pain that originates from the vertebral endplates inside the spine, often associated with degenerative changes visible on MRI. It’s different from disc herniation, muscle strain, or nerve compression.
How is the Intracept® Procedure different from injections?
Steroid or anesthetic injections provide temporary relief. The Intracept® Procedure permanently disrupts the basivertebral nerve, which can result in long-lasting relief rather than short-term symptom control.
How long does pain relief last, and what’s the recovery like?
Because the basivertebral nerve doesn’t regenerate, many patients experience sustained relief for years. Most people return home the same day and resume light activity within days, though full improvement typically develops gradually over 3+ weeks as inflammation resolves.
Is basivertebral nerve ablation considered surgery?
No. It’s a minimally invasive, image-guided procedure. It does not involve spinal fusion, hardware placement, or removal of bone or discs.
Who is a candidate for basivertebral nerve ablation?
Typically, adults with chronic low back pain lasting six months or longer who have not improved with conservative treatment and show vertebral endplate changes on MRI consistent with vertebrogenic pain.
What conditions does it not treat?
It does not treat pain primarily caused by herniated discs, spinal stenosis, facet joint arthritis, sacroiliac joint dysfunction, or nerve root compression. Proper diagnosis is essential.
Is the procedure painful?
It’s performed under anesthesia to maximize comfort. Mild soreness or stiffness afterward is common but usually temporary.
Are there implants or hardware left in the spine?
No. The procedure doesn’t involve implants, screws, or hardware, and the spine’s structure is preserved.
Is it safe?
When performed on appropriately selected patients, basivertebral nerve ablation has been shown to be safe and effective, with a low complication rate in clinical studies.
Will insurance cover the Intracept® Procedure?
Coverage varies by provider and plan, and is often dependent on diagnosis, imaging findings, and prior conservative treatment history.
How do I know if my back pain is vertebrogenic?
A comprehensive evaluation — detailed history, physical exam, and MRI review — is required to determine whether vertebrogenic pain is contributing to your symptoms.
If you’ve been told “nothing else can be done” about your back pain, it may be time for a second opinion.