Safety and effectiveness of basivertebral nerve ablation in patients with osteoporosis and osteopenia: A real-world study

Background

The Intracept procedure was the first FDA-cleared technique for basivertebral nerve ablation, a minimally invasive treatment for vertebrogenic chronic low back pain. While prior studies support its effectiveness, data in patients with osteoporosis and osteopenia remains limited.

Objective

To evaluate the safety and effectiveness of basivertebral nerve ablation with a specific focus on pain reduction, functional improvement, and the incidence of post-procedure vertebral compression fractures.

Methods

A retrospective chart review was conducted on patients who underwent the Intracept procedure at our institution from November 2019 to January 2025. Bone density status was categorized using available DEXA scans. Patients were stratified into a Reduced Bone Density group (N = 32), consisting of 23 patients with osteopenia and 9 with osteoporosis, and the overall cohort (N = 134). Pain severity was assessed using the Visual Analog Scale (VAS) at baseline and at the 4–6-week post-procedure follow-up visit, and functional improvement was determined based on patient-reported outcomes at the same time point. Post-procedure complications, including vertebral compression fractures, were monitored until the most recent available follow-up.

Results

A significant decrease in VAS was observed for the overall cohort (7.04 vs. 3.78, p < 0.001) and the Reduced Bone Density group (6.75 vs. 4.13, p < 0.001). Functional improvement was reported by 79.1 % of patients in the overall study population and 78.1 % of patients in the Reduced Bone Density group. No post-procedure vertebral compression fractures were observed in the entire cohort, with a mean follow-up length of 18.07 months.

Conclusion

The Intracept procedure demonstrated significant pain reduction and functional improvement in the overall cohort and in patients with reduced bone density. Notably, no post-procedure vertebral compression fractures were observed, even in patients with osteoporosis and osteopenia. These findings contribute to the growing body of independent literature supporting the safety and effectiveness of the Intracept procedure and offer real-world insight into its use in patients with reduced bone density.