Basivertebral Nerve Ablation for Vertebrogenic Back Pain
Basivertebral nerve ablation (BVNA) — often searched as the Intracept procedure — treats vertebrogenic low back pain from inside the vertebra. If therapy has plateaued, request a consultation with Dr. John Smirniotopoulos to review MRI and symptoms together.
Typically outpatient, with light sedation rather than general anesthesia
The procedure
Basivertebral nerve ablation for vertebrogenic pain
BVNA quiets the basivertebral nerve at the vertebral endplate. MRI may show Modic changes. It is one option among spine treatments at Full Motion Joint and Spine — not a default for every MRI, and not a promised result.
Not a large spine operation
Not fusion. Not the same as medial branch ablation for facet joints, or kyphoplasty for a fracture.
MedStar procedures
Done in the MedStar hospital setting. Visit flow is on the Locations page.
Request a consult
Request a consultation so candidacy is decided in person — not from this page.
The vertebra
Chronic low back pain when the endplate is the source
Vertebrogenic low back pain is a deep axial ache that may worsen with sitting or bending. Modic changes are a clue, not a diagnosis by themselves. This is a path toward low back pain without surgery when the bone — not a fusion-first disc — is the target.
The probe
X-ray guidance into the vertebral body
A small probe is placed in the vertebra. Radiofrequency energy quiets the basivertebral nerve. The disc and facet joints are not the target. Twisting facet pain may need medial branch ablation instead.
Candidacy
A consult if MRI suggests Modic changes
People ask about the Intracept procedure after conservative care, with chronic low back pain and imaging support. Dr. John Smirniotopoulos decides candidacy in person — not from this page.
Often discussed at consult
- Axial low back pain lasting despite therapy and injections
- MRI support for vertebrogenic pain, including Modic changes when relevant
- Interest in outpatient image-guided spine care instead of a large operation
Candidacy is confirmed in person — not from this page.
Not every disc MRI
BVNA is not for every herniation. A painful compression fracture is a different problem — see kyphoplasty.
New bowel or bladder loss, saddle numbness, fever with back pain, or trauma with sudden severe pain needs urgent care — not this page.
The visit
Your BVNA visit, start to finish
Before you arrive
MRI review is central. Eating or medicines change only if you are told. See Locations.
The day of treatment
Outpatient probe placement under imaging. Arrange a ride home.
Going home
Most people go home the same day when the visit goes as planned.
Follow-up
Everyday activity often resumes within a few days, with limits from the team. Results vary.
Afterward
Recovery after basivertebral nerve ablation
This is not fusion recovery. Soreness can occur. If BVNA is not the right match, options include conservative care, facet-directed treatment, or surgical referral when anatomy requires it.
Care led by
Dr. John Smirniotopoulos
BVNA is performed by a dual board-certified interventional and diagnostic radiologist, Associate Professor of Radiology at MedStar Georgetown University Hospital, fellowship-trained in vascular and interventional radiology (2020). Credentials are on the About page.
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Dual board-certified Interventional & Diagnostic Radiology
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American Board of Radiology
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Associate Professor of Radiology MedStar Georgetown
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Society of Interventional Radiology SIR
Before you book
BVNA questions we hear at consult
Is BVNA the same as the Intracept procedure?
Intracept is the brand name many people search. The work is image-guided ablation of the basivertebral nerve when MRI and symptoms align.
Can it help vertebrogenic low back pain?
It is used when endplate-driven pain is the story. Results vary. No outcome is guaranteed.
Is basivertebral nerve ablation outpatient?
Yes. It is typically outpatient with same-day discharge when the visit proceeds as planned.
How is BVNA different from medial branch ablation?
BVNA targets a nerve inside the vertebra. Medial branch ablation treats facet joint pain nerves.