Allegheny Health Network Expands Treatment Options for Chronic Low Back Pain

Justin Davanzo, MD

(Credit: Allegheny Health Network)

The Allegheny Health Network (AHN) Neuroscience Institute is expanding its treatment options for patients suffering from chronic low back pain (CLBP). ReActiv8 helps restore impaired neuromuscular control and can also address degeneration of the multifidus muscle, while Intracept relieves chronic vertebrogenic low back pain. Both interventions are new options for patients who are not eligible for traditional spine surgery.

“Intracept and ReActiv8 provide different treatment regimens for patients with chronic low back pain,” says Justin Davanzo, MD, neurosurgeon and director of Neurocritical Care at AHN. “Previously, these patients would likely not have been offered any surgical intervention for treatment of their pain.” Dr. Davanzo reports encouraging outcomes for both interventions, which are covered in more detail below.

Restoring muscle function with ReActiv8

AHN is the first in the region to offer ReActiv8 implantation. The ReActiv8 system addresses impaired neuromuscular control as well as degeneration of the multifidus muscle. Patients with this condition often experience chronic midline low back pain without significant radicular symptoms. Diagnosis involves a combination of history, physical examination, and imaging, including MRI evidence of multifidus muscle atrophy.

The ReActiv8 system uses neurostimulation to restore proper function of the multifidus muscle. A minimally invasive procedure is performed to implant leads near the multifidus muscle and implant a pulse generator in the gluteal region. The leads are connected to the pulse generator, which delivers electrical impulses to stimulate the muscle.

Patients begin using the ReActiv8 device two weeks after this procedure. Though results can sometimes take up to three months, patients are ultimately noting significant back pain relief with the use of ReActiv8.

Relieving vertebrogenic pain with Intracept

Intracept targets chronic vertebrogenic low back pain, a condition characterized by pain exacerbated by prolonged sitting or standing, activity, and bending forward. This pain stems from inflammation in the vertebral endplates, which are innervated by the basivertebral nerve. The presence of Modic changes in the vertebral endplates on MRI is a key diagnostic indicator.

The Intracept procedure involves a minimally invasive ablation of the basivertebral nerve, which typically takes seven to 15 minutes. The procedure is well-tolerated, and recovery is typically quick. The majority of patients see at least 50% relief of their back pain after two to four weeks, though it can take up to six weeks to see full results. Approximately 25% of patients are seeing near complete pain relief after the Intracept procedure.

“We have had multiple young patients who have presented with isolated low back pain and significant Modic changes,” said Dr. Davanzo. “Nearly all of these patients have noted significant relief of their pain that has allowed them to return to their desired activities.”

Leading the way in CLBP treatment

Dr. Davanzo’s dedication to offering these innovative approaches has significantly enhanced the level of care available to patients with CLBP at AHN. By offering these minimally invasive, targeted interventions — and as the only one to offer ReActiv8 in the region — AHN is providing hope and relief to patients who were previously limited in their treatment options.

To reach the AHN Neuroscience Institute for more information or an appointment, call 412-359-6200 or email neuroscienceinsttitute@ahn.org.