Introduction to Radiofrequency Ablation
Radiofrequency ablation (RFA), a minimally invasive medical procedure also known as radiofrequency neurotomy, is used to alleviate chronic pain and treat various conditions by disrupting nerve function. By using a modulated current, medical professionals are able to heat specific tissues, thereby disrupting the nerve signals and preventing them from reaching the brain. Over the years, RFA has become a preferred treatment for patients seeking non-surgical alternatives, particularly for managing chronic pain conditions, particularly those of the lower back, neck, and joints. Its targeted approach, combined with relatively low risks and quick recovery, makes RFA a valuable option for many patients.
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How the RFA Procedure Works
Radiofrequency ablation uses heat (up to 90 degrees Celsius for 120 seconds) produced by a focused, modulated current and delivered through a small probe within a hollow needle into nerve tissue. By denaturing (ablating) the pain fibres, the RFA prevents or stops the pain signals from being sent to the spinal cord and brain. The physician works very precisely, using imaging procedures like fluoroscopy (intraoperative x-ray guidance) to avoid affecting nearby healthy structures.
Conditions Treated by RFA
In addition to chronic pain treatment, RFA can be used to address various medical conditions, particularly those involving soft tissue abnormalities. Some of the key conditions treated with RFA include:
- Chronic Pain: RFA can be highly effective at providing relief for chronic back, neck, and joint pain. Conditions alleviated by RFA include arthritis and facet joint pain, spondylosis, sacroiliac joint dysfunction.
- Cardiac Arrhythmias: By targeting and destroying abnormal electrical pathways in the heart, RFA can restore normal heart rhythm.
Details of This Minimally Invasive Treatment
Before RFA, the physician reviews the patient’s medical history and advises against taking blood-thinning medications such as warfarin or clopidogrel, for a few days before the RFA procedure. In outpatients x rays and MRI scans will be reviewed to determine the best course of action. After that, a test called a diagnostic block (usually a medial branch block to the facet joints) will be performed to confirm the source and level of pain, in order to assess the probable level of pain relief. In some cases, the block will not provide significant relief, and the physician will determine a better treatment option than RFA. For those patients who have a favourable response to the test, however, RFA treatment will be recommended as the diagnosis is confirmed.
Procedure
During the procedure itself, the patient is monitored carefully. Sedation will be used for this daycase procedure, so that the patient can be roused and can answer questions about their usual pain. For the needle insertion and ablation, the patient will be asleep and comfortable.
For medial branch RF ablation to treat lumbar facet joint arthritis, a thin needle is inserted into the area of the tiny nerve transmitting the pain signals. This is guided by fluoroscopy, a type of real-time, continuous x-ray. Once the needle has been inserted, the doctor will ask questions about the sensation the patient is feeling, and once the right treatment location has been determined and the area anaesthetised, a radiofrequency current is sent through the needle into the targeted portion of the nerve, stopping it from sending pain signals. The RFA procedure can last anywhere from 30 to 90 minutes, depending on the number of nerves treated and where they are located. While this is a day case procedure, the patient should have a ride home and should not do anything strenuous for at least 24 hours after the treatment. There may be soreness, pain, or muscle spasms for a day or two, but normal activities, including bathing and showering, may be resumed also after a day or two. The patient may be prescribed pain medication, and an ice pack can also help alleviate pain. Physical therapy may be recommended but not usually right away, and there will be a follow-up appointment.
Benefits of RFA
Radiofrequency ablation (RFA) has several benefits, which is why it is growing in popularity across various medical fields. Here are some of the many benefits:
- RFA is minimally invasive, with a quick recovery time. There are no incisions, it is done on a day case basis, and it does not require a lengthy recovery period. In most cases, patients can return to their normal activities within a day or two.
- It is safe and has few side effects. There is very little risk of complications, since RFA does not involve major surgery. Further, RFA is a pain management technique with fewer side effects than prescription medications.
- RFA provides effective pain relief. It can provide long-lasting relief for those with chronic pain conditions. In many cases, pain relief lasts between six months and two years, making it a good option for patients who may not respond to other treatments.
- Patients need less pain medication when treated with RFA. Patients who undergo RFA often report a significant reduction in their dependence on pain medications, which can have side effects or lead to dependency issues over time.
- Reducing pain improves a patient’s function. Improved movement and agility are two of the positive outcomes known to result from RFA. Because RFA is effective, it reduces a patient’s need for surgery, which can have complications like bleeding and infection.
Risks and Side Effects
There are risks associated with any medical procedure, but risks and side effects from RFA are relatively uncommon. There is sometimes pain or burning during the procedure, typically similar to the pain the patient was experiencing from the condition being treated. This pain may last for a week or two but can be alleviated with ice packs. At the needle’s point of entry, there may be temporary soreness. Very rarely, inadvertent nerve injury or inflammation (neuritis) can occur to a nearby nerve root due to heat transfer, or the original back pain may intensify. Infection, bleeding at the insertion site, and other complications are also rare. Some patients do not achieve complete pain relief from RFA treatment. In general, however, RFA has far fewer risks and complications than traditional, open surgery.
Patient Considerations
Patients considering RFA should talk to their healthcare provider in order to understand whether the procedure is appropriate for their specific condition. Some factors to consider include:
- General Health: RFA is generally safe for most individuals, but those with certain underlying health conditions, such as bleeding disorders or intracranial pressure, may not be suitable candidates. Additionally, RFA cannot be performed on patients with a BMI of over 45.
- Infection at the Injection Site: RFA may not be performed where there is an active infection.
- Previous Treatments: RFA is often recommended for patients who have not found relief through other, more conservative treatments, such as physical therapy, medications, or less invasive procedures like nerve blocks.
- Pain Location: RFA is not suitable for all pain types or locations. It is the most effective for pain in the spine, neck, and facet joints.
- Symptom Severity: Patients with severe, chronic pain that significantly affects their quality of life may find RFA to be an ideal solution, especially if other treatments have failed.
Criteria for Selecting RFA: Who is a Good Candidate?
Not everyone is an ideal candidate for radiofrequency ablation. The procedure is generally recommended for individuals who meet the following criteria:
- Patients Suffering with Chronic Pain: Those with chronic pain conditions, particularly those involving the spine and facet joints, are often the ones who benefit most from RFA.
- Patients Seeking Non-Surgical Options: RFA is ideal for individuals looking to avoid surgery or those who are not surgical candidates due to underlying health conditions or age.
- Patients Who Have Not Responded to Other Treatments: Patients who have tried other forms of treatment, such as medications, physical therapy, or injections, without long term relief may be candidates for RFA.
- Patients With a Confirmed Diagnosis: RFA works best when the source of pain is well-understood and localised, such as specific nerve-related pain or facet joint issues.
- Patients Who Desire Long-Term Relief: Individuals seeking longer-term pain relief without the need for frequent medications or invasive treatments may find RFA appealing. For some people, pain is alleviated for years following radiofrequency ablation.
What is the cost of the procedure?
SpineArt fees due at the point of booking
Radiofrequency Ablation
A minimally invasive medical procedure also known as radiofrequency neurotomy, is used to alleviate chronic pain and treat various conditions by disrupting nerve function.
View full price list£3523*
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