Radio Frequency Neurotomy- A new ray of hope for people suffering from long standing spinal pain

Incidences of Musculoskeletal disorders are increasing, with a lot of people being diagnosed with ailments like osteoarthritis, rheumatoid arthritis, cervical, spinal stenosis etc. But despite the awareness about these diseases, little information is available on their possible cures and that too the latest one. Conventional treatment involves use of physiotherapy, pain killers and if no relief ultimately surgery. Adding to the Doctors arsenal is Radio frequency neurotomy, a form of treatment which can provide almost magical relief from the acute pain.

A little about our Spine and how it functions

Our spine is made up of 24 bones known as vertebrae, which are stacked into a column. Between each vertebra lies a cushiony part called disc which acts as a shock absorber. Each vertebra has two sets of bony knobs that meet each other. The point where they meet each other is called the facet joint. These Facet joints are responsible for motion of bending, flexing (flex forward or extend backward) and twisting (from side to side). These Facet Joints are protected by soft tissue consisting of synovial fluid which acts as a lubricant between these joints. A layer of thick white cartilage covers the joint, helping it to glide smoothly when the body moves. Over the time due to ageing/injuries, this cartilage gets damaged or gets worn out. Inflammation of these joints leads to what we know as Arthritis. A number of spinal conditions such as osteoarthritis and spinal stenosis, or from an injury to the back, such as caused in car accident, all lead to facet joint pain.

Treatment for Spinal pains

Generally, the first line of treatment for such disorders involves medicines to relieve the pain depending upon the condition of the patient. But today, a new state of the art technique using radiofrequency has emerged to treat difficult and long standing spinal pain.

A radiofrequency neurotomy is a simple day care minimally invasive non surgical procedure where the patient can go home the same day. Radiofrequency waves are electromagnetic waves which travel at the speed of light, or 186,000 miles per second (300,000 km/s). In this procedure, Radiofrequency Energy (a type of heat energy) is created by a special generator at very high or super high frequencies. With the use of this specialized generator, heat energy is created and delivered with precision to target nerves that carry pain impulses to brain. It involves numbing of the skin and tissue over the procedure site with an injection of local anesthetic. Next, the physician uses x-ray guidance, to direct a special radiofrequency needle alongside the medial nerves. Often, a small amount of electrical current is carefully passed through the needle to assure it is next to the target nerve and a safe distance from other nerves. This current briefly recreates the usual pain and cause a muscle twitch in the back. Then the targeted nerves are numbed with a local anesthetic to minimize pain.

At this stage 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 to the brain.

 There are two primary types of radiofrequency treatment: A medial branch neurotomy (ablation), this affects the nerves carrying pain from the facet joints. Another one is a lateral branch neurotomy (ablation); this affects nerves that carry pain from the sacroiliac joints.

Radiofrequency neurotomy responds well to multiple chronic pain conditions such as spinal arthritis (spondylosis), facetogenic low back pain, spinal stenosis, grade I spondylolysis, post-traumatic pain (whiplash), cervical spine, pain after spine surgery, failed back surgery syndrome (FBSS), and other spinal pain conditions. It also works well in certain neuropathic pain conditions (like Complex Regional Pain Syndrome), and some other assorted chronic pain conditions. A patient’s candidacy for this treatment is usually determined by the performance of a Diagnostic Nerve Block.

Radiofrequency neurotomy offers significant and long lasting pain relief as compared to steroid injections. Almost all patients undergoing this procedure will experience significant pain relief for a long period of time so that many patients often find a long term remission or cure for their back or neck pain. As a general rule, if effective, the ablation will often provide pain relief lasting at least 24 months and often for longer period which is very significant as patient is relieved of acute pain which no other procedure is able to provide.

This procedure being less complicated & minimally invasive without any open surgery provides low morbidity rates, appreciable pain relief compared to surgery, greater range of motion, lower use of analgesics, improved quality of life, and short recovery time.