Lumbar Radiofrequency Ablation
A lumbar radiofrequency ablation (RFA) is a least invasive procedure performed by pain management doctors, to treat low back pain caused by arthritis and degenerative changes in your facet joints of your spine. This procedure is also called a lumbar facet rhizotomy or neurotomy and targets small nerves called the dorsal medial and lateral branches that carry pain signals from your back to your brain. In this procedure, radiofrequency energy is used to create a lesion on these facet nerves to disconnect the pain signal and relieve the perception of low back pain.
Neither the dorsal medial or lateral branch nerves control any muscle or sensation in your legs. Therefore, the RFA has little to no negative impact on your functionality after the procedure.
Who Are Good Candidates For A Lumbar Radiofrequency Ablation?
Patients suffering from low back pain, resulting from inflammation, degeneration, or arthritis of the facet joints, which have failed conservative care, may benefit from an RFA. If a patient gets at least 50% or more significant relief from a medial or lateral branch block injection, this confirms that the facet joint is causing a significant portion of the pain and that the patient will get good to excellent pain relief results from an RFA. Most patients will achieve low back pain relief for about 6-18 months.
What Happens During A Lumbar Radiofrequency Ablation?
The lumbar radiofrequency ablation (RFA) is performed at a surgery center or a doctor’s office. The procedure is a least invasive, outpatient, and takes about 30 minutes. Patients undergoing an RFA tolerate the procedure well with localized skin numbing medicine or conscious IV sedation. The patient will lie down on the procedure table, and their low back cleaned, prepped, and local anesthetic injected under your skin and around the nerve branches. Using real-time X-ray called fluoroscopy, the doctor places small needles over facet dorsal medial branch nerves. These needles deliver radiofrequency energy to put a lesion on the nerves, thus disconnecting the pain signal from your back to your brain.
What Should You Expect After A Lumbar Radiofrequency Ablation?
It is normal for some patients to experience soreness around the skin injection site for a few hours. Physical activity and rest are recommended immediately after the procedure. Routine work and physical activities can be resumed the following day. Pain relief from the radiofrequency ablation typically begins immediately after the procedure, and the duration of pain relief is variable and depends on the severity of the spinal condition. Some patients will experience short-term relief 3-6 months and some up to 18 months.