Radiofrequency Ablation (RFA Procedure), (also referred to as neurotomy, is used every day to treat people with chronic lower back and neck facet joint pain) is a minimally invasive procedure to treat arthritis pain in the spine. Minimally invasive means it does not require an incision, has a lower risk of infection and a faster recovery. While this procedure is proven to have longer lasting results, it is not usually considered until other treatment therapies have proven ineffective.
In many cases it has been shown to last longer compared to steroid injections, generally around 12 months. Patients can develop permanent pain relief with the facet nerve Radiofrequency Ablation; however, if the pain returns, it tends not to be as severe, and the procedure can be repeated indefinitely.
How does Radiofrequency Ablation work?
Radiofrequency Ablation works by using radio waves to vibrate the tissue, to create a controlled disruption of the nerve, interrupting the transmission of the patient's pain. Using x-rays, the doctor places special needle(s) and electrodes (called cannulas) along the pain generating nerves. A small current is applied by a Radiofrequency generator and directed into the target area. As the current is delivered, the desired tissue is destroyed preventing the signal from getting to the spine.
What is the Radiofrequency Ablation procedure like?
The procedure is considered minimally invasive and patients will be able to go home shortly after the treatment. Before the treatment, the patient will be given local anesthetic to alleviate any discomfort during the procedure. Sedation is often provided for patient comfort and would require a driver. Needle placement is checked before every Radio frequency Ablation procedure. Safety stimulation is also provided before every Radiofrequency Ablation as an added precaution. The RF Ablation procedure generally takes between 30 to 90 minutes to complete.
1. Before Procedure
Dr. Sturm will diagnose the problem and inform the patient about the procedure. He will also answer any question the patient may have.
Dr. Sturm may ask about:
-Current medications, including herbal supplements and their dosages
-Drug, iodine, or latex allergies
-Current health conditions
2. Day of Procedure
Before the procedure, an IV (intravenous) line will be placed in a vein in your arm.
-Eating anything 6 hours before the procedure is prohibited, clear liquids are accepted up until 2 hours before the procedure.
-Patients with diabetes must adjust their insulin dosage. Dr. Sturm will go over this with you.
-Arrange for someone to assist you with transportation after the procedure.
-Discontinue pain medications 4 hours before the time of your appointment.
3. During the Procedure
During the RFA procedure, the patient lays on their stomach, conscious and often sedated. With x-ray guidance, Dr. Sturm will insert a RF needle followed by an electrode into the location.
Once placement is confirmed, a high-frequency electrical current is passed through the electrode causing heat and lesioning of the sensory nerve.
4. After the Procedure
After the procedure, patients are discharged within 1-3 hours. Initial discomfort may occur, but most patients resume normal daily functions within 1-2 days. After a few days, there should be a noticeable decrease in pain with expected continued improvement over the next several weeks.
The procedure can relieve pain for up to 2 years. However as nerves repair themselves, pain may return and the procedure can be re-performed.
Does Radiofrequency Ablation hurt?
Sedation is not required but often provided. Local anesthetic is always provided.
How do I find out if I am a candidate?
Radiofrequency Ablation is not a first line therapy for patients. Candidates are given a diagnostic nerve block(s) as required by their insurance company. Diagnostics blocks usually do not provide long term relief.