Overview
A lumbar RFR procedure is performed for pain that is caused by damaged facet joints. The aim of the operation is to temporarily paralyse the very small nerves that supply the facet joint of pain sensation. This will then bring partial or complete (but usually temporary) relief of the pain, spasm and referred pain that these damaged facet joints can cause.
The reason why your specialist performs this procedure and not a more invasive operation is because he or she is trying to be as conservative as possible in treating your condition. The aim is to treat your symptoms without resorting to a more invasive operation.
When undergoing this procedure, you will be lying on your stomach on bolsters or pillows. Your specialist will use an X-ray machine to guide the needles that are used to do the procedure with. A very thin electrode is inserted through the needles and the nerve that supplies your facet joint is stunned or damaged by radiofrequency generated by a radiofrequency generator.
During The Procedure – What To Expect
- RF rhizotomy is an advanced injection procedure.
- It's important that you remain awake during the procedure to provide important feedback to the radiologist.
- A radiologist will perform the procedure using a thin needle electrode placed adjacent to the degenerative facet joint.
- The radiologist will check the needle placement using a fluoroscope (x-ray camera), which is connected to a T.V. monitor. X-rays will be taken at this time.
- To verify the needle position, the nerve may be stimulated using low voltage electricity. The stimulation will cause the affected muscles to rhythmically contract.
- The radiologist will then use numbing medication (anesthetic) to put the nerve to sleep.
- Then the radiologist will apply heat to the nerve via the electrode for approximately 60 seconds.
- This heat is designed to create a lesion, causing the nerve to become cauterized or burnt, which in turn breaks the communication link to the brain.
- This procedure is then repeated at other levels including the levels above and below where the pain is originating.
- Throughout the procedure, a radiologist and nurse will monitor your condition and comfort level closely.
Is the Procedure Painful?
Due to the use of a local anesthetic the patient experiences very little sensation during the procedure itself, apart from an achy sensation as the needle is placed near the nerve. There may be some discomfort at the injection site once the anesthetic wears off.
Ward care
You may sometimes have a bit of discomfort directly following the procedure, but this will clear up very soon. You will be allowed to move around freely following your procedure.
Discharge
This procedure is usually performed as a day procedure, although in some cases patients may sleep over.
Rehabilitation
It is incredibly important to get a lot of rest and exercise following your surgery. It is frequently useful to supplement your treatment with physiotherapy and local treatment such as massage therapy and chiropractic treatment.
Follow up
You will usually be seen after six weeks but will be seen earlier if there are any complications. It is important to realise that you will have to protect your back the rest of your life with good back habits. See the section on exercises to see what you can do to keep your back healthy.
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