Radiofrequency ablation is a minimally invasive procedure that is usually performed with local anesthetic and mild sedation.
As with many spinal injections, radiofrequency neurotomy is best performed under fluoroscopy (live x-ray) for guidance in properly targeting and placing the needle (and for avoiding nerve or other injury).
Radiofrequency Ablation Steps
The neurotomy or ablation procedure includes the following steps:
- An intravenous (IV) line is often started so that relaxation medicine (sedation) can be given.
- The patient lies on a procedure table and the skin over the neck, mid-back, or low back is well cleaned.
- The physician numbs a small area of skin with numbing medicine (anesthetic), which may sting for a few seconds.
- The physician uses x-ray guidance (fluoroscopy) to direct a special (radiofrequency) needle alongside the medial or lateral branch nerves.
- A small amount of electrical current is often carefully passed through the needle to assure it is next to the target nerve and a safe distance from other nerves. This current should briefly recreate the usual pain and cause a muscle twitch in the neck or back.
- The targeted nerves will then be numbed to minimize pain while the lesion is being created.
- The radiofrequency waves are introduced to heat the tip of the needle and a heat lesion is created on the nerve to disrupt the nerve's ability to send pain signals.
- This process will be repeated for additional nerves.