When Rick Krump retired in April, he found himself facing persistent low back pain that had worsened after a lengthy hospital stay in 2022. Following complications from hernia surgery, Krump spent nearly a month hospitalized and subsequently struggled with depression due to ongoing discomfort.
“I’m generally an optimistic person, but I was really struggling with depression, as I was in constant pain,” Krump said. “I had minor back pain before that, but being in a hospital bed for weeks exacerbated my pain.”
After trying physical therapy and injections without success, Krump turned to opioids for relief. His physician then suggested the Intracept procedure—a minimally invasive treatment using radiofrequency heat to ablate nerves responsible for his pain.
The procedure targets vertebral endplate nerve dysfunction, also known as vertebrogenic pain. This condition arises when nerves in the cartilage between spinal discs and vertebrae become compressed or inflamed, often leading to chronic lower back pain that is sometimes misdiagnosed as degenerative disc disease.
Basivertebral nerve ablation, marketed under the name Intracept, interrupts pain signals by destroying the tip of affected nerves.
“There are many reasons for chronic lower back pain,” said Beth Gibbons, MD, FAANS, a board-certified neurosurgeon at Neurosurgery One — Castle Rock, affiliated with 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.”
Dr. Gibbons noted that this condition can be identified through MRI scans showing Type 1 or Type 2 Modic changes—indicators of inflamed bone marrow or fatty tissue caused by reduced blood flow.
In Krump’s case, Dr. Gibbons identified Type 1 Modic changes on his MRI scan. “These Modic changes were clear indications that Rick was experiencing vertebral endplate nerve dysfunction,” she said. “Patients with vertebral endplate nerve dysfunction don’t find relief with conservative treatments.”
Krump underwent basivertebral nerve ablation at AdventHealth Castle Rock in June. The outpatient procedure involved two small incisions and radiofrequency heat applied under general anesthesia to target the problematic nerves.
“I immediately experienced pain relief after the procedure and feel much better,” Krump said. “It wasn’t invasive, and I am very pleased with everything.”
Candidates for basivertebral nerve ablation typically have chronic lower back pain lasting more than six months, have not responded to conservative treatments, show specific Modic changes on MRI scans, and do not have severe osteoporosis.
Most patients return to normal activities within one or two days following the procedure and report improved symptoms within two weeks; these improvements can continue over three months. A study published in 2020 indicated that five years after undergoing basivertebral nerve ablation: 66% of patients experienced more than a 50% reduction in pain (with 34% reporting complete relief), opioid use decreased by 73%, and injections decreased by 93%.
AdventHealth Orlando is located in Orlando, Florida and has been operating since its founding in 1908. The hospital is led by president Terry Shaw and includes both pediatric care facilities and training programs for medical professionals.
