Elaine Kimbrel lived with lower back pain for years.
“It's been a journey,” says the 59-year-old medical assistant, who in December 2012 slipped on a patch of ice on her exterior stairs, flipped in the air and landed on her back. "I thought I had broken my back because I hit so hard."
Instead, she dislocated three vertebrae, leading to years of pain that never completely resolved, even after they ultimately were manipulated back into place.
But then came a referral earlier this year to interventional pain management specialist Brian Goentzel, MD, with Ascension Medical Group Via Christi, which she says proved to be a "godsend."
After determining that Elaine was an appropriate candidate, Dr. Goentzel told her about a new minimally invasive outpatient procedure designed to provide durable relief to patients suffering from chronic vertebrogenic low back pain. In layman's terms, that's a long-standing and isolated dull pain not related to stenosis or arthritis.
The Intracept system provides an implant-free treatment option for patients who have suffered with low back pain for over a six-month period and failed traditional conservative therapy.
The two-hour outpatient procedure is performed under general anesthesia, primarily to ensure that the patient remains immobile and optimize targeting of the nerve. Under the guidance of a fluoroscope, a small cannula is advanced through the pedicle, the part of the back bone that connects with the vertebral body of the spine. The cannula is used to create a channel to the trunk of the basivertebral nerve.
The access site is so small that not even a single stitch is required. "It's a Bandaid-like procedure," says Dr. Goentzel, one of only two physicians west of the Kansas City area to offer the Medicare-approved procedure for those who meet the criteria.
"One of the key benefits of this system is that it preserves the structure of the spine," says Dr. Goentzel. "We do a thermal-ablation of the nerve, but it doesn't alter the structure of the bone.
"Within three months, you probably couldn't tell from looking at the site that it ever took place," he says.
Dr. Goentzel says that for years, treatment of chronic vertebrogenic low back pain focused on the disc. As more is learned, however, the focus has shifted to the nerve supply to the back bone rather than injury to the bone.
"We can't swap out the bone and scraping out the intervertebral disc and fusing the bones doesn't work," says Goenzel. "So the idea arose, 'What if we kill that nerve and don't allow the pain signal to travel to your brain?'"
For patients like Elaine, who had suffered an injury to her back bone but no intrinsic damage, the Intracept procedure creates a roadblock to the pain, not allowing it to get through to her brain.
"You have to make sure it is the right treatment for the right patient, but we think that it is a pretty significant population that is suffering with this issue," says Goenzel, who has now used the procedure to benefit 19 patients and has half as many others scheduled.
Elaine decided to give the procedure a try. In late February, she underwent the procedure and within several weeks she could feel the difference.
“As time goes on, it gets better and better,” she says. “It's like I never even had any back pain before."
To refer a patient for whom conservative therapy is no longer effective to Dr. Goentzel for a consultation, call 316-613-4670 or fax records to 316-613-4726.