Radiofrequency Relief: RF Ablation for Chronic Back Pain

What is Radiofrequency Ablation?

Radiofrequency ablation is a minimally invasive procedure often used for the treatment of facet joint syndrome and radiculopathy. It predominantly targets the medial branch nerves that convey pain signals from the facet joints to the brain. Inflammation or degeneration of these spinal joints can result in pain radiating to the extremities, leading to common symptoms such as numbness, tingling, burning, or shooting pain. The primary objective of radiofrequency ablation is to disrupt these pain signals by precisely targeting and destroying the nerve tissue. By using radio waves and heat, small lesions are created in the malfunctioning nerves, effectively preventing their ability to conduct pain signals. This intervention has the potential to offer patients significant pain relief for extended periods.

An Overview of RFA Systems

Radiofrequency ablation procedures are facilitated by RFA systems that harmonize the functions of a variety of medical devices. These systems typically comprise components like a radiofrequency generator, an adaptor, a ground pad, and radiofrequency probes with their corresponding cannulas. The radiofrequency generator, being the heart of the RFA system, generates the radio waves and heat. It also provides an interactive interface for tweaking procedural settings. The adaptor ensures a regulated energy flow and connects the probes to the generator after their cannulas have been appropriately positioned within the patient. These cannulas, slender tubes, guide the insertion of the probes and ensure access to the target nerves. Once in place, the probes act as electrodes, delivering radio waves and heat to the targeted nerves to create thermal lesions. Moreover, the ground pad, which adheres to the patient’s body, acts as a dispersive electrode ensuring a safe return path for administered currents, thus preventing unintended tissue burns during the heating process.

Preparation and Procedure Details

Radiofrequency ablation should only be carried out by trained experts like Dr. Matthew Kohler and their supporting medical teams. Before the procedure, a detailed evaluation of the patient’s pain profile is essential. A key diagnostic criterion for this procedure is witnessing at least a 50% relief from twice repeated nerve blocks in the targeted regions. Often, medial branch blocks (MBBs) are used as a preliminary, low-risk version of the radiofrequency ablation procedure. Instead of creating a lesion, a local anesthetic (sometimes accompanied by a corticosteroid) is used to provide patients a preview of the relief they might expect post-ablation. If the relief is substantial, the procedure is typically green-lighted.

It's noteworthy that while RFA is minimally invasive, there's a comprehensive protocol to ensure patient safety and optimal outcomes. Standard practices include performing the procedure under monitored anesthesia care, using live fluoroscopy for precise needle placement, conducting motor neuron tests to prevent unintended lesions, and carefully programming the generator to achieve the desired therapeutic effects. Following the RFA, the utilized needles are sterilized rigorously.

Outcome and Considerations

The procedure's duration is typically around 30 minutes, with an analogous recovery time from anesthesia. Relief can be instantaneous for some, while others might feel relief after a few days post the subsiding of procedural soreness. Routine follow-ups are crucial to monitor recovery and detect any potential complications. Most patients can expect significant pain relief for at least six months, with some reaping the benefits for years. Many insurance plans provide coverage for repeated RFA procedures, allowing patients to sustain the relief obtained.

Radiofrequency ablation's benefits are notable, encompassing reduced surgical interventions, quick recovery, and an enhanced quality of life. However, potential risks such as infections, bleeding, and nerve damage must be kept in mind. On the whole, RFAs stand out as minimally invasive, low risk, and a promising avenue for extended pain relief.

For individuals looking to explore radiofrequency ablation as a potential solution to their pain challenges, Dr. Matthew Kohler at Ospina Medical is available for initial consultations. Drawing on vast experience and expertise, Dr. Kohler can guide patients toward the most effective pain management solutions tailored to their unique needs.

Author: Camden Rowe

Medically Reviewed By: Matthew Kohler, MD