Rhizotomy - RF Ablations

A radiofrequency ablation (RFA), also known as a rhizotomy, is a minimally invasive outpatient procedure for treating a multitude of pain conditions including post-traumatic pain (whiplash), pain after spine surgery, and spinal arthritis (spondylosis). Other conditions that are known to respond well to RFA include some neuropathic pain conditions like Complex Regional Pain Syndrome and other peripheral nerve entrapment syndromes. RFA uses radiofrequency energy to disrupt nerve function.

A patient’s candidacy for RFL is usually determined by the performance of a Diagnostic Nerve Block. Many patients who are being considered for this procedure have already undergone simple injection techniques like Epidural Steroid Injection, Facet Joint Injection, or Sympathetic Nerve Blocks, with pain relief that is less prolonged than desired. This procedure will help to confirm whether a patient’s pain improves just for the duration of the local anesthetic (or not). Radiofrequency ablation is a procedure used to provide longer term pain relief by selectively destroying nerves that carry pain impulses.   During the procedure heat energy is created and delivered with precision to target nerves that carry pain impulses. The painful structure can be effectively denervated and the pain reduced or eliminated for anywhere from a few months to up to 12 months.

Once a structure has been determined to be a pain generator, its nerve supply is targeted for interruption.  A local anesthetic will be used to numb your skin. A small insulated needle or RF cannula is positioned next to these nerves with fluoroscopic guidance (live video X-Ray). After a successful test confirms good cannula tip position, a local anesthetic is injected to numb the area. The RF generator is then used to heat the cannula tip for up to 90 seconds, and thus the target nerve is destroyed. This is often repeated at more than one level of the spine.

You will be monitored for up to 30 minutes after the RFA. When you are ready to leave, the staff will give you discharge instructions.  It is common for neck or back pain to increase for a few days or longer after the RFA procedure before it starts to improve.  You may feel sore, numb, weak, or itchy for a couple weeks. Maximum pain relief normally comes in two to three weeks. Nerves regenerate after an RFA, but how long this takes varies. Your pain may or may not return when the nerves regenerate. If it does, another RFA can be performed.

If you are scheduled to receive sedation during the procedure, you must have someone available to drive you home.  If you receive intravenous sedation, you should not drive a car until the next day. Patients are generally advised to go home and not return to work after this type of procedure. Following discharge home, you should plan on rest and if you have pain at the needle puncture sites, application of an ice pack to this area should be helpful.