Radiofrequency lesioning is a minimally invasive outpatient procedure which is used to treat the symptoms from a wide range of painful back and neck conditions.
Unlike most spinal surgeries, this particular procedure does not demonstrate the potential for curing the underlying cause of pain. In fact, radiofrequency treatment is a surgical form of symptomatic treatment.
There are actually many different methods of nerve ablation, with some being temporary and others being permanent in their effects.
Regardless of the approach utilized, the surgical goal is always the same: Identify the tissues which are signaling pain and then treat them to prevent these distress signals from being transmitted via the affected nerves.
In essence, although the symptomatic condition remains, it is no longer capable of sending messages of pain to the brain, since the neurological pathways have been disabled.
What is Radiofrequency Lesioning?
RF lesioning is performed in many back, neck and sciatica 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, even 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 Recommendations
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.
There are many other methods of nerve ablation available. Some procedures use extreme heat, while others utilize extreme cold. Simply severing an affected nerve is an antiquated solution, but this can cause some serious problems in select patients.
To learn more about various forms of nerve blocking procedures, consult with your spinal neurologist.
Radiofrequency Lesioning to Herniated Disc
9/21/09 Revised 8/19/13