What is radiofrequency spinal ablation?

Am I a candidate for radiofrequency ablation?

Radiofrequency ablation is best used for lower back pain that is limited to the spine and buttock. An ideal candidate is someone with back pain more than leg pain, and someone whose pain is worse with prolonged standing or extension but gets better with sitting.

How do I know if spinal ablation is right for me?

Making the right diagnosis is key to effective treatment. Our spine and pain management specialists at Neurosurgery One start with an exam to check that the pain remains in the spine and gets worse with standing, extension, or rotation. If those tests indicate the pain is related to facet issues, an X-ray and ultimately an MRI is needed for confirmation.

At that point, patients are referred for physical therapy as the initial treatment and may also be given spinal injections to provide temporary relief while going through physical therapy for longer relief. If those measures don’t work, our of spine or pain management specialists then consider radiofrequency spinal ablation.

How is spinal ablation performed?

Radiofrequency spinal ablation is an outpatient procedure performed at a surgical center. After the patient is sedated, a spine or pain management physician uses fluoroscopy, X-ray guidance, to reach the affected medial branch nerve. Then the physician positions a heat probe on the targeted nerve and burns the nerve ending using radiofrequency current. The current destroys the portion of the nerve that transmits pain and disrupts the pain-producing signal.

Spinal ablation takes about 30-40 minutes, with patients at the surgery center for about two hours from check-in to recovery.

What is recovery like from spinal ablation?

After the spinal ablation is completed, you will go to recovery for a short time to ensure the sedation medications have worn off and to assess your condition. Typically, patients spend about two hours at the surgery center. You will likely experience increased pain due to the procedure for about 1-2 weeks before the spine pain begins to diminish. You will be instructed to take it easy the day of the spinal ablation procedure but can return to work and regular activity the next day.

What are the benefits and risks of radiofrequency ablation?

Radiofrequency spinal ablation typically provides about 6-12 months of relief. In all patients, the nerves will grow back. In some, however, the nerves may grow back without reinstituting the pain. In patients whose pain returns, ablation can be repeated. The majority of insurance plans cover radiofrequency ablation.

The most common risk is temporary numbness at the injection site. Because the medial branches extend up into the skin, the heat from the radiofrequency may travel up those nerves and cause pain similar to a sunburn in some people who are particularly sensitive. Serious complications, such as infection or damage to the wrong nerve, occur in fewer than 1 percent of patients.