Lumbar Radiofrequency Ablation
Lumbar radiofrequency ablation targets chronic low back and buttock pain which has been previously positively treated with lumbar medial branch block. This procedure does not benefit leg pain. Lumbar radiofrequency ablation is a procedure in which the medial nerves that carry pain from the facet joints to the brain are destroyed by radio waves. The radio waves are conducted through a needle that has been placed into the facet joint or joints in the lumbar spine. This treatment would be the next step after a positive lumbar medial branch block in which pain was relieved throughout the duration of the injected local anesthetic. The radiofrequency ablation is performed in an attempt to destroy the nerves that had been previously been numbed by the local anesthetic injection in the medial branch block. Destroying the nerves produces longer-lasting pain relief. Radiofrequency ablation can be performed at more than one level of the lumbar spine during the same session.
The patient is required to be awake throughout the procedure however, and general anesthesia cannot be used. Medications designed for relaxation are given intravenously. The targeted area of the lumbar spine will also be numbed by a local anesthetic under sterile technique. Under x-ray guidance, the tip of the electrode/needle reaches the exact location near the medial nerve in the facet joint of the lumbar spine; it is numbed and then the small radio waves produce heat, destroying the nerve. If the radiofrequency ablation is successful, pain relief can be obtained and last anywhere from three weeks to six months to a year, depending on the individual. It is not a permanent procedure, however; the nerves will grow back over time and the radiofrequency ablation can be repeated.