RADIOFREQUENCY NEUROTOMY (RFA)
Radiofrequency neurotomy is a treatment designed to provide relief from severe pain in the back or neck so that advancements in vigorous back or neck rehabilitation can be accomplished. It uses the heat generated by radiofrequency waves to interfere with the nerves‘ ability to send out pain signals. The heat generated by these waves is delivered to targeted nerve areas through special needles that are inserted, just above the spinal area, through the skin.
Radiofrequency neurotomy does not usually provide permanent pain relief; its goal is to significantly decrease neck or back pain. Patients who have been previously unresponsive to more conservative methods of treatment, such as physical therapy or pain medication, are often candidates for this procedure.
Candidates for Radiofrequency Neurotomy
People experiencing chronic back or neck pain without much associated extremity pain are considered good candidates for radiofrequency neurotomy. A series of prognostic tests are performed to determine whether RFA will be beneficial for the patient. These prognostic injection can be facet – joint injections or medial branch injections.
The results of two independent prognostic injectons have to be 80% improvement both times before most insurance companies will authorize RFA. Local anesthesia is used to numb the facet joint or medial branch nerves prior to RFA, and monitored anesthesia care is provided to most patients for comfort during the procedure. It usually takes a week or two for the treated nerves to stop the painful impulses that they carry.
The Radiofrequency Neurotomy Procedure
Radiofrequency neurotomy is performed as an outpatient procedure in a doctor‘s office, and is usually completed within an hour. The procedure begins with the placement of an intravenous (IV) line into the patient‘s arm or hand. The IV is used to administer medication that keeps the patient comfortable and relaxed during treatment. A specialized X-ray machine, known as a fluoroscope, provides information that allows for the most accurate positioning of the radiofrequency needles. This ensures that only the targeted nerve tissues are affected, and that the healthy surrounding nerve tissues remain undamaged.
Risks of Radiofrequency Neurotomy
The risks of RFA vary but generally are mild. There is often pain at the needle entry sites and tylenol/ice application usually are effective. Sometimes the nerves can become inflamed buy the RFA treatment temporarily; if this is severe, oral steroids will resolve the condition quickly. Other more severe complications are rare.
Recovery from Radiofrequency Neurotomy
Patients can return home immediately following radiofrequency neurotomy. The recovery process varies from patient to patient, though most patients need only a few days to recover.
Results of Radiofrequency Neurotomy
Radiofrequency neurotomy is more successful in some patients than others. The relief that the procedure is intended to produce lasts from 6 months up to 2 years.
Radiofrequency neurotomy can be repeated if pain recurs. RFA has the most success if best efforts at building core muscle strength for back or neck are pursued after the procedure.
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