Radiofrequency Lesioning Print>
What is it?
Radiofrequency (RF) lesioning is a procedure using a specialized machine that disrupts nerve conduction along nerves transmitting pain impulses by applying heat lesions. Sedation and a local anesthetic is given. Special needles are then inserted into the affected areas. The physician will use fluoroscopy (a specialized x-ray) to guide the needles. Electrical stimulation is performed before any lesioning. This may produce a buzzing or tingling sensation. You may also feel your muscles jump. You will be allowed to awaken during this time in order to pinpoint the areas to be lesioned. Electrical current is then used to disrupt the affected nerves.
The procedure is specifically for pain emanating from facet joints. These joints are located along the entire spine on each side of the midline. Unfortunately, most other types of pain cannot be successfully treated with this form of therapy. A variant of radiofrequency lesioning called “Pulsed RF” has been utilized to treat some other types of pain. Instead of a heat lesion, it applies an electromagnetic impulse to adjacent nerves. However, Pulsed RF is considered experimental and therefore not covered under most insurance plans, including Medicare. The reported pain relief is typically less dramatic and lasts for only 2-3 months.
What are the expected results?
Pain relief from this procedure lasts until the nerves regenerate, which is typically 9 months but can range from six months to two years. Patients are typically sore for a few days after the procedure, although responses can vary. Pain relief is typically experienced within 1-2 weeks after the procedure.
How long will it take?
The procedure itself typically takes 30-60 minutes to perform. You will be observed in the recovery room for 30-60 minutes after the procedure.
What happens after the procedure?
Most often you can go home in about 30-60 minutes. Written instructions will be sent home with you. You will need someone to drive you home and care for you for the first few hours after the procedure. You will need to take is easy for the rest of the day.
What to expect the day of your procedure.
You are expected to arrive at the surgery center at least one hour before your procedure is scheduled. Bring a responsible adult driver with you because you will be receiving medications which could impair your ability to drive. Unless you are certain you will not be receiving sedation, do not eat anything for 6 hours prior to your procedure; you may have modest amounts of clear liquids (liquids you can see through) up to 4 hours beforehand. Please take your regularly scheduled blood pressure, heart, asthma, long-acting narcotic and nerve pain medications with sips of water as you normally would. If you have diabetes, take half of your normal dosage and bring your insulin with you. Be sure to discontinue aspirin products and any other blood thinners as instructed.
After you arrive, you will be asked to sign-in and complete any paperwork as needed. You will then be taken to the preoperative area. At this time, a nurse will ask you some medical questions and have you sign your consent forms. It is imperative that you, the patient, inform the assistant of any changes in your history and/or physical, such as a recent flu or any health problems that might affect your procedure. Inform the staff of any allergies, especially to Betadine or Iodine.
You may be asked to change into a gown. An assistant will take your vital signs and an IV may be started in order to provide pain relief and relaxation.
The physician and nurse will talk to you before your procedure. In certain cases an anesthesiologist may also be utilized. You will then be positioned and the injection sites will be prepped. Your pain management physician will perform the procedure. Medications are typically administered before and during your procedure to help you relax and provide pain relief. You may doze off during this time. Afterwards, Band-Aids will be applied as needed.
You will be transported to the recovery room area where you will be monitored anywhere from 30 minutes to an hour. You will be offered beverages and some crackers. After this, someone will take out your IV and help you get dressed if needed. Lastly, your caregiver will be given discharge instructions for your care at home.
