Radio Frequency Ablation (RFA or Neurotomy)
What is a Radio Frequency Ablation?
Radio Frequency Ablation is a procedure using a specialized machine to interrupt nerve conduction on a semi-permanent basis. The nerves are usually blocked for several weeks to several months.
What are the benefits of Radio Frequency Ablation?
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 long does the procedure take?
Depending upon the areas to be treated, the procedure can take from about twenty minutes to forty five minutes.
Where long does the procedure take?
The procedure is performed in our own fluoroscopy suite at our office.
How is it actually performed?
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 Lidocaine) 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 ablation. 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 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.
Will the procedure hurt?
Nerves are protected by layers of muscle and soft tissues. The procedure involves inserting a needle through skin and those layers of muscle and soft tissues, so there is some discomfort involved. However, we numb the skin and deeper tissues with a local anesthetic using a very thin needle prior to inserting the needle.
Will I be "put out" for this procedure?
No. This procedure is done under local anesthesia. Some patients may be precscibed an oral sedative for relaxation if there is any issue with anxiety. It is necessary for you to be awake enough to communicate easily during the procedure.
How is the procedure performed?
It is done either with the patient lying on the stomach. The patients are monitored with blood pressure cuff, and blood oxygen-monitoring device. The skin on the back is cleaned with antiseptic solution and then the procedure is carried out. X-ray (fluoroscopy) is used to guide the needles.
What should I do after the procedure?
We advise the patients to take it easy for a day or so after the procedure. You may want to apply ice to the affected area. Perform the activities as tolerated by you.
Can I go to work to work the next day?
You should be able to return to your work the next day. Sometimes soreness at the injection site causes you to be off work for a day or two.
How long will the effects of the procedure last?
If successful, the effects of the procedure can last from three to 18 months, usually six to nine months. It may take one to two weeks to feel peak effect.
Who should not have this procedure?
If you are on a blood thinning medication (e.g. Coumadin®, Plavix®), or if you have an active infection going on, you should let your physician know.