Incidence 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 shockabsorber. 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. All
remaining patients will also get some pain relief but for a shorter period of
time. 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.
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