Radiofrequency nerve ablation is the term used when radio waves are generated to ablate the nerve. The heat essentially destroys the nerve eliminating its ability to transmit pain signals.
- About the Procedure
What do I do prior to the procedure?
You should allow approximately 1 to 2 hours for the procedure. You will need to arrange a driver to take you home after the procedure
What nerve is ablated?
Radiofrequency ablation is used to destroy the median nerves that supply the facet joints in the spine. There are two for each facet joint. These joints are the small posterior joints on either side of the spine. These joints can be one source of back pain.
How is it determined if I am a candidate for this procedure?
Pain management using radio frequency involves three days of evaluation. Two separate trials with local anesthetic. If positive relief of pain is achieved then 3rd day the RF ablation for long term relief is performed.
1st Day Trial One: Sensorcaine:
The patient will come in and the radiologist will inject sensorcaine into the indicated area. The patient will relax in our recovery room for 20-30 minutes. The patients pain relief on a scale of 1 to 10 is documented. The patients then scheduled for a second injection of lidocaine on a separate day. The patient logs thee level of relief/duration.
2nd Day Trial Two: Lidocaine:
The radiologist injects the patient with lidocaine in the area of concern. The patient rests for 20-30 minutes in our recovery room and the degree of pain relief is documented. If the patient receives significant relief from both the injections they are a candidate for radio frequency ablation with 85% likelihood for success. If relief with one or the other trial there is a 50% likelihood for success.
What is the procedure like for the ablation?
The patient will lie on their stomach. Local anesthetic will be used to numb the treatment area. The patient should experience minimal discomfort throughout the procedure. Additional numbing medication may be administered as needed. The patient is awake during the procedure to provide feedback to the radiologist on peripheral pain.
The technique used for the nerve ablation is similar to that used for the diagnostic blocks. A thin needle is inserted down to the region of the facet joint, which is responsible for the pain. Each joint has two nerves, which supply the joint therefore, 2 needle positions for each joint will be needed. As during the trials, the placement of the needle will be under fluoroscopic guidance. Once the needle is in place you will receive a numbing medication and the radiofrequency stimulation will occur through the needle already in place. This takes approximately 90 seconds. X 2 for each needle. This will be repeated at each needle site. The needle will be removed and the procedure is complete.
What Recovery is Required?
The patient is placed in a recovery room with continuous monitoring for a short period of time. The patients back or neck may remain painful for up to 10-14 days after the procedure and is generally due to residual effects of the ablated nerve. After this period the patient will begin to feel pain relief.
What is the long-term effect of the injections?
Once the nerves which carry pain sensation from the painful joint are destroyed you should be free of the back pain you are experiencing. Pain relief may last over a period of approximately 9 months to 2 years or more. Time, physical therapy and increased muscle strength around this joint may make this joint less painful over the following 6 months so that if or when the nerves do regenerate you will not experience the same intensity of pain as prior to the procedure. If you have a recurrence of pain this procedure can be repeated.