Cutting pain at its root. Radiofrequency Neurotomy

Dr. Eduardo Rubio Ruiz. Director

Pain transmitted by a single nerve or a few nerves will generally respond well to a radiofrequency neurotomy. The following conditions may respond well to a neurotomy:

• Facet syndrome. Pain originating in the facet joints of the spine (zygapophyseal joints).
• Occipital neuralgia. Pain in the base of the skull that radiates around the eye.
• Visceral (abdominal pain). Pain that is transmitted through the splanchnic nerves. The most advanced applications include post-thoracotomy syndrome and post-hernia pain syndrome.

Preliminaries

Before you schedule a radiofrequency neurotomy, you would have a temporary nerve block with a local anaesthetic (a drug similar to novocain). The local anesthetic would numb your nerves for at least four hours. If you have a good pain relief during this period, you are eligible for a radiofrequency neurotomy.

Procedure
During the procedure, sensory stimulation is performed first. A low-voltage current is applied to the needle. Our goal is often to produce a slight sensation of buzzing or tingling or mild pain at the site of your usual pain and to make sure that the pain is not stimulated elsewhere.

Motor stimulation is then performed. Often, we will see the muscles around the spine jump with motor stimulation, but we do not want the muscles of arms or legs to move. When we are sure the needles are in the correct position, more local anesthetic is given through the needle to numb the area around the needle. The radiofrequency electrode is then placed inside the needle and the tip of the needle is heated, coagulating the nerve. You may feel some heat during this time.

Expected results

As a result of previous treatment of patients, there has been an average of 3 months to more than 2 years of pain relief, and a success rate of 70% is shown. The duration of pain relief is shorter for procedures performed on the chest, scalp, and upper spinal cord than for nerves in the lower back and lower spine. Normally you cannot judge the results of the radiofrequency neurotomy until two weeks after surgery.

You will need to take it easy for the first two weeks after surgery. You will need to use ice packs and pain relievers for the first few days. Once your pain has improved, we generally recommend that you work with a physical therapist or chiropractor on a rehabilitation program.

Important: Radiofrequency neurotomy "covers" the pain so you don't feel it. It does nothing to fix the underlying problems. If you have a problem that can be fixed, you should not have a neurotomy. Only if you have severe pain due to a problem that cannot be corrected, then you should consider a neurotomy.

Radiofrequency neurotomy was developed in the early 1950s and its safety and efficacy have been demonstrated in many scientific studies.

If you want to check if you are a candidate for this surgery, schedule your appointment with us here.