Radiofrequency Ablation

Radiofrequency ablation (RFA), also known as rhizotomy, is a minimally invasive non-surgical procedure that can reduce the transmission of pain by targeting the nerve fibers that carry pain signals from the affected part of the body to the brain. This safe and effective procedure can provide long-lasting relief to people with conditions such as chronic pain, arthritis, wear and tear to your spine and even inflammation of muscles around nerves. This procedure aims to provide an interventional method to help patients avoid major surgery. It allows patients to return to normal work and daily activities while significantly decreasing dependence on pain medication. 

Are you a good candidate for radiofrequency ablation?

To ensure that the procedure is completed safely, physicians will go through your medical history and advise you of any possible risks. Your physician will also conduct preliminary diagnostic testing to determine the areas of your body from which the pain originates. This can be done through an MRI of the spine and nerve-blocking injections that involve numbing of the pain fibers with a local anesthetic.

Once it has been determined that you are a candidate for RFA your physician will outline the steps that need to be taken preceding the procedure. During RFA procedures, patients are usually placed under local anesthesia. In preparation, patients should not eat or drink for a specific number of hours before your appointment. If you take aspirin or blood thinning medication, your physician will advise you how many days prior to the procedure you should discontinue your medications to avoid risk of bleeding during the procedure. Because the procedure is performed under sedation, it is also recommended to have a person with you for assistance with transportation because you will not be allowed to drive a car for 24 hours following the procedure.

How is radiofrequency ablation performed?

After an IV is inserted and you are sedated, physicians use X-ray guided imaging to position a needle close to the nerves responsible for your pain. Once the needle has reached the target nerves, the doctor will insert a microelectrode to begin the stimulation. Stimulation of the nerves will help them verify the optimal area for placement of the microneedle. After the area has been verified, the doctor will send a radiofrequency current through the electrode to heat tissue surrounding the target nerve. The heat will create a small and precise area of burning which destroys the nerve fibers that transmit pain to your brain. 

Following the procedure, you will be transferred to a recovery room for close observation of your vitals as the sedation wears off. The majority of patients are able to walk normally immediately after the procedure. Post procedure, there is a chance you may experience a temporary increase in nerve pain, localized numbness, or mild back discomfort. Pain at the injection site can remain for up to 2 weeks, however patients are often back to work within one to three days of the procedure. Complications following the procedure are extremely rare.

How well does radiofrequency ablation work?

Seventy to eighty percent of patients treated with RFA have reported experiencing pain relief, which can last anywhere from months to even years depending on the patient’s body and their rate of nerve regeneration. It is possible that the nerve will regrow the lesion and begin transmitting pain signals again, but this minimally invasive procedure can be repeated if necessary.

Author: Nawal Panjwani

Editor: Ospina Medical Team