Radiofrequency ablation is a minimally invasive procedure that is usually performed with local anesthetic and mild sedation.
As with many spinal injections, radiofrequency neurotomy is best performed under fluoroscopy (live x-ray) for guidance in properly targeting and placing the needle (and for avoiding nerve or other injury).
Radiofrequency Ablation Steps
The neurotomy or ablation procedure includes the following steps:
- An intravenous (IV) line is often started so that relaxation medicine (sedation) can be given.
- The patient lies on a procedure table and the skin over the neck, mid-back, or low back is well cleaned.
- The physician numbs a small area of skin with numbing medicine (anesthetic), which may sting for a few seconds.
- The physician uses x-ray guidance (fluoroscopy) to direct a special (radiofrequency) needle alongside the medial or lateral branch nerves.
- A small amount of electrical current is often carefully passed through the needle to assure it is next to the target nerve and a safe distance from other nerves. This current should briefly recreate the usual pain and cause a muscle twitch in the neck or back.
- The targeted nerves will then be numbed to minimize pain while the lesion is being created.
- The radiofrequency waves are introduced to heat the tip of the needle and a heat lesion is created on the nerve to disrupt the nerve's ability to send pain signals.
- This process will be repeated for additional nerves.
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The entire radiofrequency ablation procedure usually takes 30 to 90 minutes, and patients return home the same day.
On the day of the procedure, patients are advised to avoid driving and avoid doing any strenuous activities. Patients may continue to take any normal medications except aspirin, ibuprofen or any other blood-thinning medications, such as Coumadin.