FAQs on Radiofrequency Ablation/Neurolysis

 

Radiofrequency ablation (RFA) is a therapeutic treatment options that involves the use of radio waves to create electric current. Because nerve roots are destroyed, the procedure is called neurolysis. Heat is applied to nerve tissue to destroy the nerves, which results in a semi-permanent disturbance of pain signal transmission from the spinal cord to the brain.

What are the benefits of radiofrequency ablation?

Many clinical studies have shown that radiofrequency ablation leads to reduction in spinal back pain compared to conventional treatment measures. This is due to the disruption of nerve function. The reports have suggested that pain reduction can be sustained for up to 12 months. Other benefits include being able to have the procedure done outpatient and the ability to repeat the procedure as necessary.

What conditions are treated using RFA neurolysis?

Pulsed radiofrequency and continuous radiofrequency are the two types of RF ablation. These methods have proved effective for disrupting pain signal transmission from specific nerves. Conditions treated with this procedure include:

  • Facet joint arthritis
  • Lower back pain
  • Lumbar radiculopathy
  • Chronic cervical pain
  • Cervical radiculopathy

How is radiofrequency ablation done?

Radiofrequency ablation is performed in a medical facility as an outpatient procedure. Once you arrive, a nurse has you change into a gown and places an intravenous catheter in your arm. You are positioned face-down on the table, and a sedative is given through the IV line. The back/neck region is cleaned with an antiseptic, and the doctor numbs the skin and deeper tissues with an anesthetic (bupivacaine or lidocaine).

The procedure needle is guided into the facet joint, or positioned near the nerve root, using real-time x-ray (fluoroscopy). The heat is applied to the nerves, and the current produces a tingling sensation. An anesthetic and/or corticosteroid may be injected to help reduce post-procedure inflammation and pain. The doctor may ask you about what you are feeling during the procedure. After the needle is removed, a bandage is applied.

What can I expect after RFA?

After the procedure, you are moved to the recovery area where a nurse monitors your condition for 1-2 hours. As you wake from sedation, you will feel dizzy, groggy, and have a dry mouth. Expect some mild discomfort over the injection sites. We recommend that you rest for 2-3 days. It can take for up to one month for the targeted nerves to lose function.

What are the restrictions after the RFA procedure?

After radiofrequency ablation, you will have to follow some restrictions. These include:

  • Driving or operating heavy machinery should be avoided for 24 hours afterwards.
  • You cannot bathe for 24-48 hours, and must take showers for a week.
  • Vigorous activity must be avoided for 3-6 days.
  • Do not soak in a tub or swim for 48 hours.
  • Do not remove the bandages for a few days, and make sure the injection site does not get wet.

Does radiofrequency ablation work?

According to many clinical studies, radiofrequency ablation and neurolysis is a safe, effective procedure for offering long-term pain relief. In a recent study, found that all patients reported significant pain reduction at the 1-, 3-, 6-, 9-, and 12-month follow-up. The efficacy rate was found to be 85%, and two patients had pain relief that lasted 3 years after the initial RFA procedure.

Resources

Kastler A, Aubry S, Barbier-Brion B, et al. (2012). Radiofrequency Neurolysis in the Management of Inguinal Neuralgia: Preliminary Study. Vasc & Intervent Radio, 262(2).