Radiofrequency Ablation

aka. Rhizotomy, Neurotomy

 

Description

 

Radiofrequency ablation (RFA) is a procedure performed to treat facet joint pain.  Facet joints are located along the entire length of the spine from the neck to the lower back, where one vertebra slightly overlaps another. These joints guide the spine’s movement.  Each arthritic and painful facet joint sends the pain signal up to the brain via a very small nerve called the medial branch.  RFA deadens the medial branch nerves with the use of thermal heat via radiofrequency waves from a specialized probe.

 

How It’s Performed

 

After the patient is given a local anesthetic (numbing medicine for the skin/muscle/fat), a special radiofrequency needle is guided through the numbed skin/muscle and down to the area of the facet joint medial branch nerves.  Dr. Faubel watches on a live low-dose x-ray machine called a fluoroscope as he guides the needle to make sure it goes into the correct area.  The x-ray allows for precision and safety.  Once Dr. Faubel is sure the needle is in the correct area, he will numb the nerve with a local anesthetic (lidocaine 2%).  At this point, the radiofrequency machine tests to make sure the needles are in the correct position.  Lastly, a heat lesion is generated to deaden the now numbed up nerves. 

 

Candidates For This Procedure

 

If you have neck, low back, buttock, or sometimes upper back and upper leg pain stemming from inflammation, irritation or arthritis of your facet joints, you may benefit from a facet joint radiofrequency ablation.  A thorough history and examination by Dr. Faubel will help to determine this.  

 

In order to qualify for the radiofrequency ablation procedure, health insurance plans require successful pain relief of 80-100% for 3+ hours with each of two (2) medial branch blocks, usually one week apart.

 

How Long Does The Procedure Take

 

The entire procedure usually lasts about 20-30 minutes.

 

Recovery

 

No recovery is needed.  Muscle pain for a couple days after the procedure may occur.  After a cervical (neck) radiofrequency ablation, patients will occasionally experience a sunburn-type feeling for a few weeks.

 

Instruction After The Procedure

 

No baths, hot tubs, or other submersion of the injection sites for 24 hours after the procedure.  You can otherwise do activities and work as tolerated.

 

Results

 

If the facet joints are the cause of the pain, the patient will experience immediate pain relief for 3-5 hours (the duration of the lidocaine medicine) because it is used before the heat lesion is started.  The real relief from the radiofrequency procedure is felt within the first week, but can rarely take up to three (3) weeks to get the full effect.  Pain relief can last up to 2 years, though most insurance companies are willing to pay for a repeat procedure if it lasts for at least 6 months.