Radiofrequency (RF) Ablation is a procedure using electrical impulses to interrupt nerve signals for 6 to 18 months. The targeted nerves are those carrying signals from the painful facet joints in the back and neck. The procedure provides prolonged pain relief from degenerative and painful facet joints in the spine.
How Does it Work?
The Radiofrequency ablation probe creates a heat source that essentially “burns” the signal carrying portion of the nerve. By destroying these fibers, the nerve can no longer pass painful signals to the spinal cord and brain. The nerve fibers will eventually grow back in 6-18 months, thus allowing a return of pain.
How Is It Done?
After the patient is given some slight sedation and the skin is anesthetized, the RF needle is directed to the nerve to be treated using X-ray(fluoroscopic) guidance. The RF probe is inserted and the target nerve is stimulated to confirm proper needle placement. A buzzing or tingling sensation may be felt initially, followed by muscles twitching. It is important to tell the physician what is felt during stimulation. After some local anesthetic and possibly a steroid is injected, the nerve will be “burned” for about 90 seconds. The needle is then removed, and the procedure will be repeated to treat the next nerve. Often, several nerves must be “burned,” to provide complete pain relief.
What Are The Risks?
As with any invasive procedure there are some risks associated with radiofrequency ablation. Any time a needle is put into the body, there is a risk of infection, bleeding and allergic reaction. The risk of infection is prevented by using sterile techniques. The risk of bleeding is very minimal if patients are not on any blood thinners. There are very few allergic reactions to the medications that are used for the injection. If any allergic reactions are identified, medications will be given and patients will be observed to prevent any serious complications. Steroids, if used, may have several side effects that are limited due to the small amount of medication used in the procedure. There is a risk of semi-permanent injury to a spinal nerve leading to prolonged weakness and/or numbness. The risk of this serious complication is very low, because the targeted nerves are stimulated prior to “burning.” The stimulation confirms that the correct nerves will be “burned.”
What Can I Expect After?
Most patients will have some soreness that usually improves in about 3-4 days. It may take up to three to four weeks to develop pain relief, as it may take that long for the nerve to stop transmitting pain signals. Icing may help with any discomfort. Most patients go home about 20-30 minutes after their injection. Patients are advised to rest on the day of the injection, but may return to their normal activities the next day. Patients should make a follow-up appointment after the procedure.