Radiofrequency Lesioning

Radiofrequency lesioning is a minimally invasive outpatient procedure which is used to treat a wide range of painful back conditions. Unlike most spinal surgeries, this particular procedure does not demonstrate the potential for curing a dorsopathy syndrome. In fact, radiofrequency treatment is a surgical form of symptomatic treatment.

What is Radiofrequency Lesioning?

RF Lesioning is performed in many back pain patients whose conditions can be traced to particular nerve structures. High tech neurological testing often makes for relatively accurate diagnosis of involved nerves and can target those neurological structures responsible for sending pain messages to the brain. In RFL, the surgeon will insert a needle with a tiny electrode into the back and place the electrode as close to the affected nerve as possible. This is accomplished under fluoroscopy to better visualize the area, but still involves a bit of guess work and estimating, since the actual nerve can not be visualized. Once in place, the electrode sends out electric current which will disrupt the signaling capability of the affected nerve. This disruption does not kill the nerve, but merely temporarily ends its pain causing pattern.

Radiofrequency Lesioning Indications

In herniated disc patients, RF lesioning is usually used to block signals from a suspected compressed nerve root. Of course, this neurological compression is medically identified far more often than it actually occurs and many of these cases are misdiagnosed. In these cases, the pain is typically due to an ischemic pain condition using the herniated disc as a scapegoat for symptom production. Regardless, if the source of pain is due to oxygen deprivation of the identified nerve, the surgery should still work.

The downside to this treatment is its symptomatic nature. The cause of the pain is not cured and once the RF lesioning wears off, the pain will likely return and statistics show it might come back worse than before. This treatment only lasts 6 to 12 months on average and subsequent treatments have a tendency of lasting even less time. On the up side, this procedure is short at less than 1 hour, relatively effective for numerous types of pain and involves very low risk.

Radiofrequency Lesioning Advice

As always, I recommend saving ANY type of surgical intervention until all conservative options have failed. That being said, RF lesioning might buy you some pain free time to further investigate your options for actually curing the condition once and for all. In these situations, I can see the point of the procedure. As a stand alone solution, RFL is a hands down loser, since it is little more than a temporary fix.

RFL, like epidural injections, offers hope to many patients who enjoy the benefits of the pain relief, but do not immediately consider the fact that these modalities are indeed temporary. Most patients also do not think about the chances of subsequent rounds of treatment being less effective or consider the chance that their pain WILL likely return in full. If you are using one of these modalities to treat back pain, remember to keep looking for a permanent solution while you enjoy the short term pain relief offered. If not, the pain will eventually return and you will be right back where you started…

Radiofrequency Lesioning to Herniated Disc Home
9/21/09