Thermal Radiofrequency Ablation

Overview

Ablation with radiofrequency technology is a method of pain relief that is more durable in its effects than facet blocks or injections. By eliminating the nerve fibers that transmit pain signals to the brain, this procedure is effective. Individuals who suffer from chronic facet joint discomfort may utilize this pain relief technique. Lumbar facet joint pain is characterized by discomfort in the neck, torso, and lumbar regions. You are a candidate for radiofrequency ablation if you have received a dose of facet block and suffer from recurrent, chronic pain. Radiofrequency signals are electromagnetic signals that generally propagate at the speed of light. It is a property of thermal energy that a singular generator emits at a high frequency. It delivers energy to the central nerves responsible for precisely transmitting pain signals using the superheated generator.

Conditions Treated

RFA can be utilized to treat a variety of persistent pain conditions. Spinal pain conditions such as post-traumatic pain (whiplash), spinal arthritis (spondylosis), pain following spine surgery, and others are among those that respond favorably to this treatment method. Additionally, certain neuropathic pain conditions (e.g., Complex Regional Pain Syndrome or RSD), peripheral nerve entrapment syndromes, and various chronic pain conditions have been identified as conditions that may exhibit a response to RFA. Above all, it is most effective for patients suffering from chronic back and neck pains, as well as joint degeneration-related pains caused by arthritis. RFA is utilized to treat facet and sacroiliac joint discomfort in the spine.

The procedure / What to expect

The purpose of a facet block is to identify the origin and site of discomfort. A local anesthetic is injected into a facet pain joint in the lumbar, thoracic, or cervical spine as part of a facet block. In the event that the structure is identified as the source of discomfort, an interruption to the nerve supply is implemented.A radiofrequency cannula is introduced in close proximity to the nerves under the guidance of a live video X-ray fluoroscope. RF cannula shaft insulation is protective, with the exception of the uppermost 5 to 10 mm. The insulation facilitates the propagation of the electric current from the upper portion of the cannula into the adjacent tissues. Upon the physician’s confirmation that the cannula shaft is properly positioned, an examination will be performed wherein a limited quantity of electric signals across various frequencies are passed through the cannula tip.This test is critical because it informs the physician of the specific nerve’s proximity to the cannula point, which cannot have an adverse effect on other nerves. For an assay to be considered positive, the cannula point must be properly positioned. A local anesthetic is administered via insertion in order to elicit a shock to the nerve segment. Thus, after approximately one and a half hours of heating the cannula tip with the radiofrequency generator, the targeted nerve is damaged.

Benefits

Recent studies conducted by a variety of medical professionals indicate that 21% of patients who underwent radiofrequency ablation experienced complete pain relief. Sixty-five percent of the patients who underwent the procedure reported experiencing moderate pain relief. An advantageous characteristic of RFA is its application in the treatment of arthritis, low back pain, and neck pain. Additional advantages of radiofrequency ablation consist of:

1. Facet pain is also treated with RFA. These are frequently described as intense and aching sensations.
2. The percutaneous ablation procedure, in which needles are inserted into the epidermis, is marginally invasive, carries minimal risk, and does not necessitate hospitalization.
3. The cost of radiofrequency ablation is lower in comparison to alternative procedures.
4. The rapid recovery and procedure time associated with radiofrequency ablation can facilitate prompt initiation of chemotherapy for patients who are in dire need of it.

How does it work

RFA operates by grounding wads that are in contact with the patient’s skin and disseminating electric current from the cannula electrode. Electrocurrent is transmitted across a spectrum of radiofrequency signals.The tumor cells are eradicated when the currents that are directed to the target nerve generate heat in the vicinity of the needle electrode. As a result, the heat waves generated by the microwave energy obstruct the blood vessels’ opening, thereby preventing any hemorrhaging. Scar tissue, which gradually diminishes, replaces the cancer cells that have been consumed. RFA operates by discharging an electric current within the microwave energy spectrum. In order to assist the physician in directing the cannula conductor into the intended nerve, computed tomography, ultrasound, or magnetic resonance imaging may be utilized. Although it is not mandatory, moderate anesthetic is frequently administered to patients throughout the procedure. Deep sedation is deemed an unsafe technique to employ during RFA procedures. Patients who have undergone RFA for neck pain and low back pain frequently experience a period of increased strength for several days.

How many treatments do I need?

Some patients benefited from the initial procedure. Should the initial procedure fail to provide complete pain relief, you will be recommended to undergo a follow-up radiofrequency ablation or touch-up procedure within a period of two to three weeks. It is important to note that RFA is not a permanent procedure; therefore, it can be repeated if its effectiveness wanes.

When will I feel better

The duration of pain relief may range from nine to twenty-four months. A recurrence of the discomfort may be attributed to the burned lesion that is a consequence of the radiofrequency ablation procedure. It will take between six and twelve months for the nerve to regenerate following the procedure. The RFA procedure has demonstrated a success rate of 80% among patients who have previously underwent a never block. The procedure may be repeated if necessary. Adolescents who suffer from facet pain due to minor tension or trauma may obtain lasting pain relief. Facet discomfort in the elderly caused by osteoarthritis may resolve within a few months.

After the procedure

You are typically required to take a transport home after a procedure that is sedated, assuming you received one. Patients must refrain from exerting any force for the following couple of days following the procedure. Conversely, one may engage in physical activities that are compatible with their physique. Its packets ought to be applied to the treated areas. The effects of radiofrequency ablation, if successful, may persist for a duration of three to eighteen months, although the majority of patients typically observe a reduction to six to nine months.

Is this procedure right for me? What are the risks/benefits?

It might be difficult to anticipate whether or not the radiofrequency ablation will be effective. Overall, patients who have undergone effective facet block are more likely to exhibit favorable outcomes following RFA.

Side effects.

RFA is a procedure characterized by minimal risk and complications. As with any other medical procedure, complications and adverse effects are possible. Although this complication is uncommon, it is vital that you are cognizant of the potential adverse effects. A few days after treatment, the infection, bleeding, discomfort, swelling, and bruising that are among the adverse effects subside. Additional complications that may arise include:

Anxiety that is transient in nature; localized numbness. Rare, but severe pain following ablation may persist for several days and necessitate the use of a narcotic to alleviate. Insufficient analgesic effects induced by the medications utilized during the procedure were documented in fewer than 20% of the patients.

Risks that may occur

Muscle discomfort will be the initial symptom, persisting for approximately six days following the procedure. One possible method of alleviating the pain associated with the soreness is by applying ice compresses. A few days later, the pain might progressively diminish.

1. Any procedure involving skin penetration carries the potential for infection.
2. Facet block has the potential to induce allergic reactions, which are invariably to x-ray contrast or steroids. Local anesthetic-induced allergic reactions in patients are uncommon.
3. Shoulder pain, biliary duct destruction, gallbladder inflammation persisting for several weeks, and bowel injury are all potential complications associated with radiofrequency ablation, contingent upon the site of anesthesia.
4. A minority of patients may experience post-ablation syndrome, characterized by influenza-like symptoms that manifest three to five days following the procedure’s conclusion and persist for an average of five days.
5. A negligible number of patients may develop a localized infection known as an abscess at the site of nerve ablation within three to four weeks. After the completion of the procedure. In order to treat the localized infection, tube drainage and antibiotic prescriptions will be required. Patients with a connection between the bile duct and the loop of colon are susceptible to developing an abscess.
6. It is crucial for women to inform their pain physicians in the event that they become expectant.