What is Radio Frequency Ablation (RFA) ?

What is Radio Frequency Ablation (RFA) ?

What is Radio Frequency Ablation (RFA) ?

0

For certain people,  the source of back pain is the irritation associated with cartilage wear in the facet joints of the spine.  This wear and tear cause the nerves from that particular facet joint to excite,  and causes pain.  The typical pain is a back pain,  that localizes to the lower back,  and buttock,  or in the neck,  the base of the neck,  into the trapezius muscles.  Based on testing such as MRI’s or even CT scans,  the degeneration of those joints can be identified.  As discussed many times in my previous blogs,  the findings on MRI’s or CT scans however,  may not correlate to your spine pain,  as there can still be many sources of neck and back pain.   These studies must be considered with the physical exam findings.  If the pain,  the physical exam findings and the diagnostic studies match a particular pattern,  you can go to the next step,  which I will discuss shortly.

For now,  I want to give examples of when the complaint,  the physical exam findings and testing are consistent with a known pattern,  and when it is not:

EXAMPLE # 1.   Correlation of Complaint,  physical exam and Diagnostic Testing:

Mary is a 40 year old female,  who has developed continued low back pain.  She recognizes the pain is worse in the morning when she first gets up.  When she bends backwards,  it reproduces a pain that radiates to the same area of the buttock on the right side.  Initially,  she had improvement with the use of over the counter ibuprofen,  but with increasing activities,  she has that same reproducible back pain to the right side.  Her physical exam was consistent with irritation to the right lower back along the facets.  Her Family Doctor was successful in ordering a back MRI.  It shows arthritis changes to the right lower back facet joints at L4-5, and L5-S1.

In this example,  Mary has a very consistent back pain complaint,  with a consistent physical exam,  and testing findings of facet arthritis located on the right side,  which is the side of the pain.

EXAMPLE # 2.  Complaints do not match the Findings on Testing:

Joe is a 45 year old male,  who has developed continued low back pain.  He cannot identify a particular pattern to the pain.  He just knows it is there,  and getting worse. There is a significant family history of back pain.   He has been to the ER on several occasions.  He has run out of the medications prescribed.  At times,  the pain is bearable.  When stressed out,  he notices the pain has worsened.  He has had back pain on and off since a work injury years ago.  His physical exam identifies pain to the whole back.  He describes a pulling sensation to the thighs at times.   His family doctor did get an MRI.  It shows disk degeneration findings at every level of his spine,  with a small disk herniation and bone spur at the L4-L5 level.

In this example,  it is not clear what the MRI is identifying other than diffuse degeneration.  It is not clear if the pain is a genetic problem,  a problem specific to the disk degeneration,  a problem from the disk,  or a diffuse overuse muscle issue.

In the first scenario,  injections to the right lumbar facet joints may give relief.  In the second scenario,  any injection treatments may be just a process of elimination,  and any benefit may be a short term relief associated with the cortizone injected into the body.

If there is good relief of pain from the Facet Joint Injections,  then the Physician may have identified the source of the pain,  the degeneration of the facet joints of the lower back .  If there is reproducible pain relief with these injections,  there is a potential for longer term relief by stopping the pain nerve signals from that facet joint.  The nerve  from the facet joint is usually follows a specific route.  If the nerve can be turned off by impairing it on that route,  it can have a  much longer pain relief effect.  That turning off of the nerve to the Facet Joint can be accomplished by the so called RADIOFREQUENCY ABLATION Procedure of the Spine.

 

While not all patients are candidates for this procedure,  it has been very helpful for the properly selected person.  Please consider a consultation to see if you are a candidate for the procedure.

 

 

Citations

  • Beyaz SG, İnanmaz ME, Zengin EŞ, Ülgen AM. Combined Use of High Radiofrequency Disk Ablation, Annulus Modulation, and Manual Nucleotomy in a Patient with Extruded Disk Herniation. Pain Pract. 2016 Jun;16(5):E74-80. PubMed PMID: 26991910

No comments

Leave a Reply

Your email address will not be published. Required fields are marked *

*
*

Disclosure Statement

The information provided on this website does not provide or should be considered medical advice. It is not a substitute for diagnosis or treatment of any condition. The information provided is for informational purposes only. You should not rely solely on the information provided on this website in making a decision to pursue a specific treatment or advice. You should consult directly with a professional healthcare provider.

As a condition of using the information on this website, ShimSpine and its physicians are not responsible for any advice, diagnosis, treatment or outcome you may obtain.

ShimSpine.com is completely self-funded. No outside funds are accepted or used. This website does not utilize paid advertising as a source of revenue.

This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information:
verify here.

Author and Contributor to www.Spine-Health.com – July, 2015

www.Spine-Health.com/author/john-h-shim-md-facs

Chief of Surgery, Mease Countryside and Mease Dunedin Hospitals, Safety Harbor and Dunedin, Florida. 2014-2016.

Orthopaedic Section Chief Mease Countryside Hospital; Safety Harbor, Florida Mease Dunedin Hospital; Dunedin, Florida.2008-2013

Board Member Morton Plant Mease Research Council

Co-Director of Mease Neuro-Ortho Spine Center Mease Dunedin Hospital; Dunedin, Florida.

One of “6 Spine Physicians Ranked #1 on Google” – December 2016

Top Ten Most Liked Spine Surgeons on the Internet – July 2016

2016 Spine Surgeons to Know list – January 2016

2014 Spine Specialists to know list – September 2014

One of Ten Leaders of Certified Spine Programs – December 2011

 

The Best Orthopedics in Tampa

The information provided on this website does not provide or should be considered medical advice. It is not a substitute for diagnosis or treatment of any condition. The information provided is for informational purposes only. You should not rely solely on the information provided on this website in making a decision to pursue a specific treatment or advice. You should consult directly with a professional healthcare provider.

As a condition of using the information on this website, ShimSpine and its physicians are not responsible for any advice, diagnosis, treatment or outcome you may obtain.

ShimSpine.com is completely self-funded. No outside funds are accepted or used. This website does not utilize paid advertising as a source of revenue.
Outpatient Spine Surgery Considerations. www.Spine-Health.com. January 2016.

What is Spinal Stenosis? www.Spine-Health.com. October 2015.

Surgeon insights on the Changing Landscape of Orthopedic Care. OrthopedicToday. June 2014

Chapter 33: Interspinous Spacers. Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

Chapter 35: Minimally Invasive Percutaneous Lumbar Fusion Technique.Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

March 2010 Minimally Invasive Transforaminal Lumbar Interbody Fusion American Academy of Orthopaedic Surgeons Annual Meeting New Orleans, Louisiana February 2010

February 2010 A Review of Dynamic Stabilization in the Lumbar Spine Selby Spine Symposium; Park City, Utah

November 2009 Lumbar Spinal Stenosis Community Based Lecture; Tampa, Florida

September 2009 Instructor/Proctor Minimally Invasive Lumbar Cadaver Lab; Tampa, Florida

February 2009 New Spinal Technology: Cervical Disc Replacement and Interspinous Spacers. Selby Spine Symposium; Park City, Utah

February 2008 The Degenerative Spine: The Role of Dynamic Lumbar Stablization and Interspinous Spacers Selby Spine Symposium; Park City, Utah

October 2008 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

September 2007 Emerging Technology in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

October 2006 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

May 2005 The Role of Kyphoplasty in the Treatment of Vertebral Compression Fractures Mease Neurosciences Symposium; Clearwater, Florida
Please note all articles, blogs and Q&A’s on this site are general information and are not to be used as medical advice for individuals. No specific diagnosis or treatment should be made based on this information. Only a physician can provide you with advice specific to your situation. Please followup with your physician if you would like to discuss your individual condition.

If you are having a medical emergency,  contact your Doctor immediately,  or go to the Emergency Room.
ShimSpine and ShimSpine.com is committed to honoring and respecting the privacy and anonymity of the individuals using its website(s) and/or services. The purpose of this Privacy Policy is to inform the individuals about the collection, processing and protection of information done by ShimSpine what information we collect, why we collect this information and how we use this information.

This Privacy Policy will be reviewed regularly to reflect the up-to-date practices of ShimSpine.