Chronic low-back pain can have many causes, which means identifying the source of pain is an important first step toward determining the appropriate treatment. Two minimally invasive procedures gaining attention are VIA Disc NP and Intracept. Although both are designed for specific types of chronic back pain, they target very different structures.
We asked Dr. George Arcos of Continuum Surgery Center of Naples to explain these procedures in terms patients can understand.
Health & Wellness: Dr. Arcos, let’s start with VIA Disc NP. What is it designed to treat?
Dr. Arcos: Some chronic low-back pain originates from degeneration of the intervertebral discs. Think of the discs as cushions between the vertebrae. The center of each disc, called the nucleus pulposus, contains tissue that helps the disc absorb shock and maintain its cushioning properties.
As a disc degenerates, it can lose water and tissue, which can affect its ability to perform that function. VIA Disc NP is designed to supplement tissue within a degenerated disc using processed donor nucleus pulposus tissue. The goal is to supplement the patient’s existing disc tissue and support the disc’s cushioning function.
Health & Wellness: How is VIA Disc NP delivered?
Dr. Arcos: It is a minimally invasive, image-guided procedure. Through a small access point, we carefully position an instrument within the affected disc and deliver the allograft material into the nucleus pulposus.
The important thing is that this treatment is not appropriate for every patient with back pain. We first have to determine whether the disc is actually the source of the patient’s symptoms. That requires a thorough medical history, physical examination and review of diagnostic imaging.
Health & Wellness: What should patients know about the evidence surrounding VIA Disc NP?
Dr. Arcos: The clinical data are encouraging, including studies showing improvements in pain and function following treatment, but research continues. Patients should understand that this is not a universal treatment for back pain, and candidacy needs to be determined on an individual basis.
Health & Wellness: Now let’s talk about Intracept. How is it different?
Dr. Arcos: Intracept targets a completely different source of pain. In some patients, chronic low-back pain originates from the vertebral endplates—the areas at the top and bottom of the vertebral bodies next to the discs.
A nerve called the basivertebral nerve carries pain signals from this region. Intracept uses radiofrequency energy to ablate, or disable, the basivertebral nerve. By targeting that nerve, the procedure is designed to interrupt the transmission of pain signals from the vertebral endplates.
Health & Wellness: Who may be a candidate for Intracept?
Dr. Arcos: Patient selection is very important. Intracept is intended for adults with chronic low-back pain lasting at least six months who have not responded adequately to at least six months of conservative treatment. They also need MRI findings consistent with Modic Type 1 or Type 2 changes in the appropriate vertebral levels.
That means someone simply having chronic back pain does not automatically qualify. We need to determine whether the patient’s symptoms and imaging are consistent with vertebrogenic pain.
Health & Wellness: What happens during the Intracept procedure?
Dr. Arcos: It is a minimally invasive, image-guided procedure. Using specialized instruments, I create a small pathway through the vertebral body to reach the basivertebral nerve. Once the position is confirmed, radiofrequency energy is delivered to the nerve. The instruments are then removed.
There is no spinal fusion and no permanent implant involved. The procedure is designed to specifically target the nerve believed to be transmitting pain from the vertebral endplate.
Health & Wellness: What is the biggest misconception about these treatments?
Dr. Arcos: The biggest misconception is that there is one procedure that treats every type of back pain. There isn’t.
Back pain can originate from different structures, including discs, nerves, facet joints and vertebral endplates. Our job is to determine where the pain is coming from before recommending treatment.
Health & Wellness: What would you tell someone who has been living with chronic back pain and feels they have exhausted their options?
Dr. Arcos: I would encourage them to have another conversation with a qualified physician. If conservative treatments have not provided adequate relief, there may be additional treatment options worth discussing.
The field of interventional pain management continues to provide minimally invasive approaches for appropriately selected patients. But the first step is always understanding the source of the pain. Once we identify the pain generator, we can discuss the potential benefits, risks and alternatives and develop a treatment plan that is appropriate for that individual patient.
For more information call (239) 331-8551, or visit:
www.jaffesportsmedicine.com.
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Continuum Surgery Center of Naples
239-504-0004
6750 IMMOKALEE ROAD, STE. 211, NAPLES, FL 34119
www.continuumsurgerycenter.com
info@continuumsurgerycenter.com