Radiofrequency ablation, also known as RFA is a minimally invasive procedure performed in an outpatient clinic to treat neck, back, facet joints, and sacroiliac joint pain. It involves the use of radio waves pulsing at a high frequency that temporarily disable the nerves from transmitting pain signals to the brain. Relief can last three to six months. Radiofrequency ablation treatment could be an option to manage chronic back and neck pain. There are other names, but the radio frequency concept is the same. They are:
Chronic neck, back, and hip pain take a significant toll on the body. Finding the right treatment can make all the difference. However, it does not work for everyone. For those that might have tried other non-surgical treatments to manage the pain, including physical therapy and steroid injections, that did not bring relief then radiofrequency ablation could be another treatment option.
Radiofrequency Ablation Benefits
Pain relief compared to steroid injections lasts longer
Relief exceeds that of injections
It is a non-surgical procedure
Complication risks are low
Opioid or other analgesic medication is reduced
Quick recovery
Improved quality of life
Relief can last six months to a year, and longer
Pain Reduction
Before undergoing radiofrequency ablation, a doctor must pinpoint the nerves causing the neck, back, or sacroiliac joint pain. They will perform a nerve block injection to determine if there is temporary relief from the pain. If there is temporary relief it means that the origin of the pain was found. This could qualify to become a candidate for radiofrequency ablation.
A Medial branch block is performed to diagnose the facet joint/s that are causing the pain.
Asacroiliac joint block is performed to determine if and which sacroiliac joint is causing the pain.
Preparation
The doctor will give instructions on how to prepare for the procedure. Instructions can vary from those listed, as every patient’s case is unique.
Do not eat 6 hours prior to your procedure
Wear loose, comfortable clothing
Easy to put on shoes
Have a designated driver for after the procedure
Make sure the doctor knows about all medications, vitamins, supplements, and herbs being taken
Follow the doctor�s instructions when taking prescribed and over-the-counter medications. This includes vitamins, supplements, and herbs
Bring all medications on the day of the procedure to be taken with minimal interruption
Radiofrequency ablation usually takes an hour or longer depending on the extent of the treatment. One example could be the number of facet joints being treated.
The Procedure
The patient will be positioned face down on the treatment table. Pillows are offered and positioned for optimal comfort. The area where the treatment will be administered is sterilized. The areas of the body not undergoing the treatment are covered with a sterile covering. Sedation could be utilized but not heavy sedation. More than likely it will be what is known as twilight sedation.
A local anesthetic is injected into and around the area/s being treated. Because radiofrequency ablation involves electricity a grounding pad is attached to the calf of one of the legs. The treatment table is adjusted for the precise placement of the needles and electrodes. The doctor will use fluoroscopy or a real-time x-ray as a guide.
Once the needle/s and electrode/s placement is confirmed, a low electrical current is sent through the electrodes. This creates waves of pulsating energy that stimulate and change the nerve/s sensory tissue so it does not send pain signals. Some individuals report a warm or mild pulsing sensation. When finished, the electrodes and needles are removed. The treated area is cleaned up, sterilized and bandages are applied.
After the Procedure
After the procedure, the patient is sent home with a set of recovery instructions. An example could be:
Keep the bandages in place
Don’t take a bath or shower
A shower can be taken the following day and the bandages removed
Do not perform any strenuous activity for up to two days
When the anesthetic wears off, the individual will have soreness and some mild pain around the treatment area. As long as everything is fine individuals can return to work and normal routine within three days. Full recovery can take up to two weeks for the treated/ablated nerves to stop sending pain signals. Although the nerves no longer conduct pain, it is temporary and not a permanent fix. This is because the nerves grow back. If the cycle starts over, talk with the doctor about another session.
Peripheral Neuropathy Relief & Treatment
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Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
Minimally invasive spine surgery known as M.I.S.S is an option to traditional open surgical procedures, as well as an alternative when non-surgical approaches are working but the pain or condition is becoming worse, regardless. These are performed to treat a variety of spinal disorders like:
Bone spurs
Degenerative disc disease
Herniated disc
Scoliosis
Spinal instability
Spinal stenosis
Spinal tumors
Minimally invasive surgery can offer potential benefits. These include
A small/tiny incision/s
Minimal cutting through soft tissues like ligaments, and muscles
Outpatient option/s
Reduced post-operative pain
Quicker recovery
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The Focus of Spine Surgery
There are two main goals when it comes to spine surgery or rather the goal/focus of the surgery. These are decompressing and stabilizing the spine.
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Decompression of the spine
Spinal decompression involves removing any tissue/s that are compressing/pinching the nerve structures like a spinal nerve root or the spinal cord itself. Bone spurs and fragments from a herniated disc are the types of tissue/s that can cause neural compression.
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Stabilization of the spine
An abnormal movement of one or more levels/segments of the spinal cord can cause back pain, neck pain, or both. Surgeries that are meant to stabilize and stop these abnormal movements utilize spine instrumentation combined with fusion.
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Spine Surgery Techniques
Minimally invasive spine surgery techniques include:
Rather than cutting through soft tissues, a tubular retraction instrument generates a tunnel that expands and passes between the muscle/s to access the spine’s column. Then an endoscope or a tiny video camera goes in and around the area, projecting a visualization of what’s happening on a monitor during the procedure.
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This is the surgeon’s/team’s eyes as they work to repair the damage. The surgery is run through the tubular retraction system along with any specially designed instruments that are needed. Types of surgical procedures performed with minimally invasive surgery include:
Discectomy
Microdiscectomy
Foraminotomy
Microforaminotomy
Microlaminectomy
Microlaminotomy
The micro means that the surgery is done using a special microscopic camera to view the disc/s and nerve/s. Imaging scans, systems, and image-guidance technologies, like fluoroscopy, which is a real-time x-ray are utilized during the surgery pinpointing the key aspects of the patient�s spinal anatomy. The surgical imaging shows 2D and 3D views, which guides the placement of any instrumentation, like pedicle screws.
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Disorders Treated with Minimally Invasive Surgery
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Degenerative disc disease
Degenerative disc disease is known as DDD often develops progressively in older adults and affects the intervertebral discs. The normal wear and tear of cellular age-related changes in the body can cause the spine’s discs to:
Stiffen
Lose Flexibility
Loss of Strength
Loss of Height
Lose shape, along with the ability to absorb/distribute the forces associated with moving
These structural changes increase the risk of disc herniation and subluxations.
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Herniated discs
A herniated disc also called a slipped, bulging, and ruptured disc. This happens when the soft gel cushion of a disc breaks through the protective outer layer. Other than the damaged disc, the loose interior gel can also irritate and inflame the nerves causing back pain. �
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Scoliosis
Scoliosis is an abnormal sideways curve of the spine that can cause progressive spinal deformity. A scoliotic curve can look like an �S� or �C.� Most cases have no known cause, and while the condition is more commonly associated with children, adults can develop scoliosis, as well.
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Spinal stenosis
Spinal stenosis happens when the spinal nerve roots and the spinal cord become compressed/pinched. These nerves branch off the spinal cord and exit the spinal canal through passageways called neuroforamen. Nerve and spinal cord compression can cause symptoms like:
Pain
Weakness
Tingling sensations
Numbness
Sometimes, pain can travel into the arms or legs
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Spine Surgery Risks
With any spine surgery there are potential risks and complications that can occur. Here are some possible complications that can happen during and after surgery, with both open and minimally invasive procedures.
Minimally invasive spine surgery does offer many benefits:
Tiny incision
Less pain
Reduced risk
Faster recovery
Let’s not forget that M.I.S.S is still surgery. Less than 5% of people with back or neck pain need spine surgery and, surgery is the last resort for treating pain and symptoms caused by a spinal condition/disorder.
It is only when non-surgical treatments like chiropractic, acupuncture, physical therapy, medication, or spinal injections do not reduce symptoms in 3 to 6 months. This is when you qualify to be a candidate for spine surgery. There are certain types of spinal disorders that require urgent or immediate surgical intervention.
Talk with your doctor, chiropractor, or spine specialist about the pain, the symptoms, and compare the results of the different therapies/treatments and go from there. With any type of surgery there are many considerations to discuss before making a decision to treat back or neck pain and if minimally invasive surgery could be an option.
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