Cervical Procedures

CERVICAL MEDIAL BRANCH RADIOFREQUENCY ABLATION

Cervical medial branch radiofrequency ablation (RFA) is an outpatient procedure used to treat pain in the cervical region – typically the neck, shoulders and upper back. Cervical RFA works by using radiofrequency energy to destroy the medial branch nerves that are transmitting pain from injured facet joints without surgery.

Facet joints are the joints in the spine that allow it to bend forward and backward and rotate side-to-side. Each joint contains medial branch nerves which are responsible for sending pain signals to the joint if something is wrong – for example, if the joint is injured or if there is inflammation.

For chronic conditions for which there is no cure, such as arthritis, cervical RFA can be extremely effective, as it destroys the medial branch nerves and reduces pain.

IS CERVICAL MEDIAL BRANCH RADIOFREQUENCY ABLATION RIGHT FOR ME?

In order to determine whether you are a good candidate for cervical RFA, your doctor will likely perform a series of medial branch blocks which involve injecting medication directly onto the nerve(s). Depending on your body’s response to the medial branch blocks and how your pain changes in response to them, your doctor may or may not recommend cervical medial branch RFA.

WHAT IS THE PROCEDURE LIKE?

Cervical medial branch radiofrequency ablation is an outpatient procedure that typically takes about 20 minutes to perform. A local anesthetic is used to numb the skin around the area being treated. Once the area is numbed a thin needle is inserted near the facet joint. The needle is guided by fluoroscopy (real-time X-ray) to right area of the spine.

To doctor will stimulate the medial branch nerve to make sure it is the correct one. When the right nerve is located, the doctor will allow the special needle used for RFA to heat up. After about 90 seconds, the heat will limit the nerve’s ability to transmit pain. This is often repeated at more than one place to improve the chances of the treatment working.

Some patients find the treatment uncomfortable. If you feel discomfort during the treatment, your doctor can give you more anesthetic or adjust the needle.

WHAT KIND OF PAIN RELIEF CAN I EXPECT AFTER CERVICAL RFA?

After you have cervical medial branch radiofrequency ablation, your doctor will likely ask you to start a pain diary to keep track of how your pain changes in the days and weeks after the procedure. Many people feel sore for 5 days to 2 weeks after the procedure. However, after that, pain symptoms tend to decrease significantly. For most patients, maximum pain relief takes about two weeks. Results may last as long as two years.

Interested in learning more about cervical medial branch radiofrequency ablation for neck pain? Call (859) 282-2024 today to make an appointment and to find out whether the treatment is right for you.

STELLATE GANGLION BLOCK / SYMPATHETIC BLOCK

The stellate ganglion is a network of nerves that is located in the front of the neck (near the collarbone), between the seventh cervical vertebra and first thoracic vertebra. When individuals experience pain or excessive sweating in the face, neck, chest, arms and/or hands, the stellate ganglion may have a role in mediating this pain. In these cases, a stellate ganglion block (sympathetic block) may be used.

A stellate ganglion block is a local anesthetic injection that is administered by a doctor at the site of the stellate ganglion. It can be used to:

• Diagnose the cause of pain
• Reduce or eliminate pain symptoms
• Reduce sweating in the head, face and upper extremities
• Treat reflex sympathetic dystrophy and complex regional pain syndrome

ABOUT THE PROCEDURE

A stellate ganglion block is an outpatient procedure. It typically takes about 10 minutes and can be performed under twilight sedation (a mild dose of general anesthesia).

WHAT TO EXPECT AFTER STELLATE GANGLION BLOCK TREATMENT

Immediately after the procedure, your pain may lessen significantly or go away altogether. For lasting results, the procedure will likely need to be repeated. The number of injections necessary to get optimal results varies from person to person. You may see longer-lasting results after each subsequent injection.

If the stellate ganglion block does not relieve your symptoms, your doctor will discuss other treatment options with you and help you choose the right course of action.

To learn more about stellate ganglion injections or other treatments for head, neck and upper extremity pain, call (859) 282-2024 to speak with one of our pain management experts.