Herniated disc nerve ablation is a form of symptomatic treatment using minimally invasive surgical practices to relieve pain. Nerve ablation has long been a mainstay of the back pain treatment industry and doctors have found new and innovative ways of accomplishing the goal of decreasing nerve signals in people with chronic pain.
What is nerve ablation and how does it work? Is nerve ablation right for your pain? What are the risks and benefits of the procedure? These questions are always relevant to the discussion of ablation surgery and we will address them during the course of this focused dialog.
This post explores the use of minimally invasive nerve ablation procedures in herniated and degenerated disc patients.
What is Herniated Disc Nerve Ablation?
Nerve ablation is a method of pain management utilizing minimally invasive surgical techniques to decrease a nerve’s ability to signal pain. Herniated and degenerated discs do not feel any pain themselves. They can only create pain when a neurological tissue (spinal nerve or spinal cord) is compressed due to the disc bulge or the lack of intervertebral space, or when a ruptured disc leaks irritating proteins onto sensitive nerve tissue (chemical radiculitis).
Nerve ablation can address any of these causative issues. The procedure seeks to deaden the affected sensory nerve so that it will no longer signal pain to the brain. This objective can be accomplished using various different approaches to care:
Diathermy is the process of using heat to damage the nerve temporarily or permanently. Heat waves can be introduced into the affected nerve using multiple forms of technology. The most common form of diathermy is radiofrequency ablation, but other wave forms can be used, as well.
Cryotherapy uses extreme cold to damage nerves temporarily or permanently. The idea is basically the exact same as diathermy, but with the exact opposite mechanism of action; cold vs. hot.
Severing a nerve is an older solution than treating it with heat or cold. This approach is still used when permanent nerve ablation becomes a goal instead of repetitive temporary treatments.
Nerve Ablation Pros and Cons
Nerve ablation has some definite selling points:
It works! Ablating a nerve will generally reduce any pain that is experienced by that nerve.
The effects of quality ablation can last for weeks or even months. If multiple procedures are successful and do not produce major unwanted side-effects, then the nerves can be disabled permanently as a curative option.
Nerve ablation is truly minimally invasive. Most procedures only utilize a needle or thin catheter that is used to target the affected nerve. There are no large incisions utilized and little chance for scarring.
Since the procedure is very minor, most people can have it performed as an outpatient. Recovery time is also a nonissue, with resumption of usual activities possible almost right away.
Nerve ablation is typically fully covered under medical insurance.
There are also some downsides of nerve ablation that every patient must know before considering it as an optimal therapeutic path for their chronic disc pain:
Results of ablation are temporary, unless the nerve is severed permanently. This means that multiple procedures will have to be performed in order to maintain relief. This can mean minor surgery several times a year.
Nerve ablation often fails to deliver good results. This does not occur because the treatment is ineffective. Instead, the most common reason for poor outcomes in terms of pain relief is misdiagnosis. As we write throughout this website, most herniated discs are misdiagnosed as the source of pain. If the treated nerve is not the symptomatic source, then of course the treatment will fail.
There can be minor or severe side effects. Sometimes, the ablation can affect motor nerve or autonomic nerve tissues, causing problematic consequences, like decreased functionality, paralysis or autonomic dysfunction. These can all be serious issues, but are likely to be temporary.
There are some risks of the procedure itself, including spinal fluid leak, nerve damage, infection and continued bleeding.
Herniated Disc Nerve Ablation Guidance
Nerve ablation is best utilized in cases where there is no doubt about the nerve being the primary source of pain. Ablation techniques allow for complete relief in some instances, without the need for more dramatic spinal operations like discectomy, artificial disc implantation or spinal fusion.
However, in most cases, the results of ablation are transient and therefore qualify as symptomatic care. However, even with this downside, if the technique is successful, it can help to confirm the diagnosis towards more permanent curative care, like disabling the nerve permanently or for use as a guide during the future spinal surgery options mentioned above.