Radiofrequency lesioning

What is it:

Radiofrequency ablation is a procedure using a specialized machine that generates radiofrequency current. A special needle is placed next to the nerve which carries pain from spinal facet joints to the spinal cord. The radiofrequency current is passed through the needle. The current generates heat or other physical forces which interrupts transmission of pain. These nerves recover function slowly with time. Radio Frequency Lesioning is a procedure using a specialized machine to interrupt nerve conduction on a semi-permanent basis. The nerves are usually blocked for 6-9 months (can be as short as 3 months or as long at 18 months).

Purpose:

The procedure disrupts nerve conduction (such as conduction of pain signals), and it may in turn reduce pain, and other related symptoms. Approximately 70-80% of patients will get good block of the intended nerve. This should help relieve that part of the pain that the blocked nerve controls. Sometimes after a nerve is blocked, it becomes clear that there is pain from the other areas as well.

How is it Done:

Since nerves cannot be seen on x-ray, the needles are positioned using bony landmarks that indicate where the nerves usually are. Fluoroscopy (x-ray) is used to identify those bony landmarks. A local anesthetic (like Novocaine) is injected to minimize the discomfort. After confirmation of the needle tip position, a special needle tip is inserted. When the needle is in good position, as confirmed by x-ray, electrical stimulation is done before any lesioning. This stimulation may produce a buzzing or tingling or pressure sensation or may be like hitting your "funny bone". You may also feel your muscles jump. You need to be awake during this part of the procedure so you can report what you�re feeling. The tissues surrounding the needle tip are then heated when electronic current is passed using the Radio Frequency machine, for a few seconds. This "numbs" the nerves semi-permanently.
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