Radiofrequency Ablation (Rhizotomy)

 

Radiofrequency Ablation (or RFA) is a non-surgical therapy procedure used to reduce chronic pain symptoms that are associated with arthritis of the spine.  During the procedure, heat is delivered to targeted nerve tissues, thereby preventing pain signals from reaching the brain.

Procedure:

  • An intravenous (IV) line is often started so that relaxation medicine (sedation) can be given.
  • The patient lies on a procedure table and the skin over the neck, mid-back, or low back is well cleaned.
  • A small area of skin will be rubbed with numbing medicine (anesthetic), which may sting for a few seconds.
  • The physician uses x-ray guidance (fluoroscopy) to direct a special (radiofrequency) needle alongside the medial nerves of the back.
  • A small amount of electrical current is carefully passed through the needle to assure it is next to the target nerve and a safe distance from other nerves.
  • The targeted nerves will then be numbed to minimize pain while the procedure is completed.
  • The radiofrequency waves are introduced to heat the tip of the needle. This will disrupt the nerve’s ability to send pain signals.
  • This process will be repeated for additional nerves.

Pain Relief:

Depending on the cause and location of the pain, relief can last from six months to a year.  Less frequently relief can last over a year.

Side effects:

RFA has proven to be a safe and effective way to treat some forms of pain. It is generally well-tolerated.  Additional benefits of this treatment include;  being able to perform the procedure in an outpatient environment, needle insertion precision, and being able to repeat the procedure if needed.

  • Swelling and bruising at the site of the treatment: This generally goes away after a few days.
  • Infection and bleeding at the insertion site: Your doctor can advise you about your particular risk.
  • Leg numbness:If you have any leg numbness, walk only with assistance. This should only last a few hours and is due to the local anesthesia given during the procedure.
  • Mild back discomfort:This may occur when the local anesthetic wears off and usually lasts two or three days. Apply ice to the area the day of the procedure and moist heat the day after the procedure if the discomfort persists. You may also use your usual pain medications.

Preparation for RFA:

  • Do not eat within six hours of your appointment; however, you may have clear liquids until two hours before the procedure.
  • If you have diabetes and use insulin, you must adjust the dosage of insulin the day of the procedure. Your primary care doctor will help you with this adjustment. Bring your diabetes medication with you so you can take it after the procedure.
  • Continue to take all other medications with a small sip of water. Bring all medication with you so you can take it after the procedure.
  • You will need to bring someone with you to drive you home after the procedure. You should not drive or operate machinery for at least 24 hours after the procedure.

Recovery:

  • You will stay in a recovery area under observation for about 1 hour. A nurse will check your blood pressure and pulse.
  • A bandage will be placed over the injection site.
  • The nurse will give you a beverage and review your discharge instructions with you.
  • Someone must drive you home.

Restrictions after RFA:

  • Do not drive or operate machinery for at least 24 hours after the procedure.
  • You may resume your normal diet.
  • Do not engage in any strenuous activity for the first 24 hours after the procedure.
  • Do not take a bath for one to two days after the procedure; you may shower.
  • You may remove any bandages in the evening before going to bed.