What is radiofrequency ablation?
Radiofrequency ablation, also known as a rhizotomy, is a minimally invasive, non-surgical procedure that uses heat to reduce or stop the transmission of pain. Radiofrequency waves kill or burn a nerve that causes pain, especially the transmission of pain signals to the brain.
Radiofrequency ablation uses an electrical current to heat a small area of nerve tissue and stop sending pain signals. Provides permanent relief to those with chronic pain, especially in the back, neck, and arthritic joints. This procedure is commonly used to treat chronic pain and spinal conditions such as arthritis (spondylosis) and sacroiliitis.
It is also used to treat pain in the neck, back, knee, pelvis, and peripheral nerves. Advantages of radiofrequency ablation: Avoidance of surgery, immediate pain relief, reduced recovery time, reduced need for pain relievers, better performance, and faster return to work and other activities.
Who is the candidate?
Diagnosis Radiofrequency ablation is a treatment option for patients who have experienced successful pain relief after injection of nerve/pain receptor blockade.
Radiofrequency ablation is done under fluoroscopic guidance (X-rays) and should not be done in people with infection, pregnancy, or bleeding problems.
What are the risks?
The risk of complications from radiofrequency ablation is very low. Serious complications, including infection and bleeding at the incision site, are rare.
Temporary side effects include:
- Weakness or numbness in the legs
- Swelling and bruising at the incision site
How is radiofrequency ablation performed?
First, you will be given medications through an IV to help you relax. Then you will fall face down or on your back on the x-ray table. The doctor will numb your skin area with a local anesthetic. So he or she inserts a fine needle into the area where you feel pain. X-rays can help your doctor identify the exact area
Insert the microelectrode through the needle. Ask your doctor if you feel tingling. This will help your doctor identify the correct area for treatment. Sends a small radiofrequency current through the electrode to heat the nerve tissue. You can usually go home the same day after the procedure.
How effective is radiofrequency ablation?
Most patients experience some pain relief after radiofrequency ablation, but this amount varies with pain and position. Relief lasts six to 12 months. For some patients, the relief lasts for years.
What happens before treatment?
The doctor performing this procedure will review your medical history and previous imaging studies to plan the best site for the ablation. Be prepared to ask yourself any questions you may have at this appointment. Patients taking aspirin or blood thinners should stop taking it several days before the procedure.
Discuss any medications with your doctor, including the person prescribing the medicine and the doctor who gave the injection. The procedure is usually performed in a special procedure room for patients with access to fluoroscopy. Arrange for someone to drive you to the office or patient center on the day of the abortion.
What happens during treatment?
During the process, you will be asked to sign consent forms, list the medications you are currently taking and if you have any drug allergies. The short procedure can take at least 15 to 45 minutes, followed by a recovery period.
Step 1: Prepare the patient
The patient lay on the x-ray table. Local anesthesia is used to numb the treated area. The patient experiences minimal discomfort throughout the procedure. The patient is alert and aware of the feedback process to the physician. Low-dose sedatives like valium or versed are usually the only medications given for this procedure.
Step 2: Insert the needle
The nerve ablation technique is similar to that used for diagnostic blocks. With the help of a fluoroscope (special X-ray), the doctor will insert a thin, hollow needle into the area causing the pain. Fluoroscopy allows the doctor to view the needle in real-time on a fluoroscopic monitor to see where the needle is going. Contrast can be injected to ensure correct needle position. Some discomfort may occur, but patients often experience more stress than pain.
Step 3: Deliver the heating flow
Once the needle is in place, the patient suffers from cramps. Next, a small, precise burn the size of the tip of a cotton swab sends a radiofrequency current through a hollow needle called a wound. The current destroys the part of the nerve that transmits pain and interferes with the signal that produces pain. The burn takes about 90 seconds at each site and can burn multiple nerves at the same time.
What happens after the treatment?
Most patients return immediately after the procedure. After supervising for a while, you can usually leave the office or suite. Someone has to take you home. Patients may experience pain for up to 14 days from this procedure, but this is usually caused by the residual effects of nerve ablation or muscle spasm. Patients typically go up and down 24 to 72 hours after the procedure.
Pain relief is generally experienced within 10 days, although in some patients relief may be immediate and in others, it may take up to three weeks. Patients should schedule a follow-up appointment with the prescribing physician to document efficacy and post-procedure to address any issues with the patient for future treatments and evaluations.
After the procedure, you may develop sores in the destination area for a few days. Rare complications include infection, bleeding, and nerve damage. Pain relief lasts from 9 months to more than 2 years. There is the possibility of nerve regeneration through a burn created by radiofrequency ablation. If the nerve grows back, it will take 6 to 12 months after the procedure.
Radiofrequency ablation is effective in those with 70-80% successful nerve blocks. This procedure can be repeated if necessary. Although results vary from patient to patient, the effect of ARF lasts from 3 to 12 months. Oftentimes, the nerve eventually regenerates, and in some cases, joint pain can return.