What is Radiofrequency Lesioning or ablation?


Radiofrequency Lesioning is a procedure using electrical impulses to interrupt conduction on a semi-permanent basis. The radio frequency waves are used to produce heat on specifically identified nerves. The nerves to be ablated are identified through injections of local anesthesia prior to the procedure during medial branch blocks. By generating heat around the nerve, its ability to transmit pain signals to the brain is destroyed, thus ablating the nerve.


Who needs this procedure?


Patients who have responded to previous facet nerve blocks or medial branch blocks with greater than 80% relief in symptoms can benefit from this procedure. The blocks are used in effort to identify the source of the pain. The RFA procedure helps to permanently reduce the pain in the back or neck. The procedure takes about 40-60 minutes. Pain relief can last anywhere from six months to two years.


How is the procedure performed?


The patient is given mild anesthesia to minimize discomfort. After numbing the skin with generous amount of local anesthetic, a special needle is advanced near the pain causing nerve under X- ray guidance. The pain causing nerve is tested to confirm the correct placement of the needle before the nerve is numbed with lidocaine solution followed by the Radiofrequency Ablation.


What are the risk and complications?


It is generally a safe procedure. But as with any interventional procedure, it carries a small risk of potential complications such as bleeding, infection, leaking spinal fluid & injury to blood vessels or nerves in and around the spine.


What should I expect after the injection?


Immediately after the injection, you may feel that your pain may be gone or quite less. This is due to the local anesthetic injected. This will last for a few hours. The heated nerve may cause an initial sensation of burning or numbness as it is dying that may last 3 weeks. The neck and lower back pain should be reduced from 6 months up to 2 years duration. The procedure may be repeated as the nerves grow back and the pain returns around the facet joint.