Radiofrequency Block Procedure

Radiofrequency lesioning is a procedure in which sensory nerves are purposefully altered by a heated probe. This technique is usually performed for focal back or neck pain caused by degenerative facet joints. Facet joints are the true synovial joints that connect your posterior spinal column. They are subject to degeneration and inflammation and become a very common cause of pain, especially in the elderly. Each facet joint is innervated by two sensory nerves, and their location is predictable along the bony spine. A diagnostic block of each nerve with local anesthetic will determine which of the presumed facet joints is the cause of pain. If you feel significant pain relief after the diagnostic block, then you will return for the radiofrequency lesioning procedure.

The aim of radiofrequency lesioning is reducing your pain and improving your functioning. The procedure is not permanent; however, recent studies have determined that the average pain relief lasts nine months. As with any procedure, there are potential risks, such as infection, bleeding, nerve injury, and worsened pain.

The procedure is performed at an outpatient surgery center. An IV (intravenous) line is started pre-operatively in order to give you a mild sedation. You are then brought to the procedure suite and placed in the prone (face down) position. Your skin is cleansed with an antiseptic solution, and drapes are placed to maintain a sterile field. The physician uses an x-ray machine to visualize your spinal anatomy and the intended targets. Next, your skin and subcutaneous tissues are anesthetized with a local anesthetic. A special needle is then inserted and placed next to the sensory nerve. Sensory and motor testing is then performed by a special machine, which informs the physician of his proximity to the sensory nerve. When appropriate, the physician will give you some local anesthetic prior to heating the needle. The lesioning (heating) process itself only takes 90 seconds.

After the procedure, there may be some slight discomfort from the process of needle insertion. Usually, the procedure is very well-tolerated, and you can resume your normal activities the next day. The full effect can take several days, so you may not perceive any immediate benefit. Radiofrequency lesioning can be repeated on an as-needed basis.

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