RADIOFREQUENCY ABLATION (RFA)
Radiofrequency ablation (RFA) is a medical procedure that uses high-frequency electrical current to cauterize or ablate structures within the body. One of the most common uses of radiofrequency ablation is to treat spine pain that is caused by arthritis of the facet joints (spondylosis) in the lower back, mid-back, or neck.
Facet joints are structures in the spine that connect the vertebrae (spinal column bones). They work as a cohesive unit and allow movement. Each vertebral segment has two facet joints, one on each side. These joints provide stability and control but also allow for motion in the spine, so that we can bend and twist. The nerves that supply these facet joints are called the medial branch nerves. These small nerves feed out from the facet joints in the spine and carry pain signals from the facet joints to the brain.
Like all the other joints in the human body, they can get damaged due to injury or deteriorate with age. When this occurs, the medial branch nerve can send painful nerve signals up the spinal cord and the brain. Pain and muscle spasms may be felt in the lumbar, middle or cervical spine.
If the facet joint pain has been properly diagnosed (typically by performing a medial branch nerve block) and pain symptoms do not go away after several nerve block treatments, radiofrequency ablation (RFA) may be recommended.
The procedure uses advanced technology to disrupt nerve conduction in an affected facet joint in order to prevent the nerve from sending pain signals to the brain. It provides more long term pain relief and is extremely safe. Results may last between twelve and eighteen months.
Cervical RFA can be recommended for chronic conditions for which there is no cure, (such as arthritis) because it destroys the medial branch nerves and reduces pain.
WHAT TO EXPECT FROM THE PROCEDURE
RFA is performed with the patient lying on the stomach or on the side of the procedure table.
The physician will use an X-ray camera (called a fluoroscope) to look at the spine and will receive a small amount of numbing of the skin using Lidocaine. Once the patient is numb, the physician will place a small needle through the skin and guide it to the location of the facet joint nerve (the medial branch or paravertebral nerve).
Once the correct spot is found, the location will be tested for accuracy. This test consists of passing a small amount of electrical energy through the nerves; the patient may feel a sensation similar to a TENS unit or an E-stim for a few seconds.
After this, the nerve will be numbed with Lidocaine or Marcaine, and then treated with Radiofrequency energy for 60-90 seconds. After this, the needle is removed.
WHAT TO EXPECT AFTER RFA TREATMENT
After the procedure it is common to feel a bit sore for a couple of days. Many people feel sore for 5 days to 2 weeks. However, after that the pain symptoms tend to decrease significantly. Ice, anti-inflammatories, and rest can help, and after that, pain symptoms tend to decrease significantly.
Note that after the procedure pain relief can be immediate, but for most patients the pain relief takes about a week or two.
The results may last up to two years.