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RADIOFREQUENCY
Nerve fiber endings are
embedded in soft tissue and in normal use are constantly being heated
and cooled, stretched and squeezed. They are subject to trauma,
inflammation, and infection, like other body tissues. When a nerve is
damaged or injured, it dies. Within a short time new nerves are formed.
This process is the basis for radiofrequency.
What is Radiofrequency?
Radiofrequency heat is
used as a means to lyse (partially or totally destroy) nerve tissue.
Radiofrequency provides partial to complete interruption of the nerve
fibers innervating involved areas and produces significant, lasting
relief and a return to normal activity as well as gainful employment.
After evaluating the results of diagnostic nerve blocks, such as Lumbar
Sympathetic Blocks or Facet Joint Injections, where pain relief has been
achieved (even if it is short term reduction/relief of the pain,) the
patient may be considered a candidate for the nerve to be destroyed to
provide long-term relief of pain.
Where is this Procedure Performed?
The patient will
require use of outpatient services: OR room, use of fluoroscopy (a type
of x-ray), and the radiofrequency machine. Dr. Columbus uses a needle
electrode that has a sharp point. The point permits the direct
penetration of the skin. The procedure is done under fluoroscopy to
permit her to directly visualize the area's bones and joints. This
allows the exact area to be identified for radiofrequency ablation.
Describe the Procedure
When the appropriate
site is located, a nerve simulator is turned on briefly. Dr. Columbus
looks for movement in the area around the insertion site or for movement
in an arm or leg (depending on the nerve to be lysed.) When this has
been completed, Dr. Columbus heats up the needle electrode to lyse the
nerve area. The destruction of the nerve interrupts the pathway of the
pain impulses to the pain. After several months the nerve begins to
regenerate itself, establishing a healthy, pain-free pathway.
At the end of the
procedure, a simple self-adhering bandage is placed over the area of the
needle electrode placement. The patient is transferred from the special
x-ray procedure room. After the patient has met recovery standards, the
patient is discharged home or to an in-patient hospital room.
Anticipated Reactions Following Procedure
Patients may be sore
around the area of needle electrode insertions for several days. Moist
heat, massage, and pain medications may be used to reduce this pain.
Most patients are sent to occupational or physical therapy for
instruction in a Home Exercise Program. Patients are usually allowed to
increase their activity level over several weeks following the
procedure.
Follow-up
Patients return to the
physician for routine follow-up visits to give progress reports on pain
reduction and report their adherence to the Home Exercise Program as
instructed.
Who Best Benefits from this
Procedure?
Patient populations who may benefit
from radiofrequency ablation include:
Low Pack Pain
Cervical Pain Syndromes
Neuralgias
Radiculopathy
Headaches
Chronic pain involving the Sympathetic Nervous System
Chronic Malignant Pain
Who should avoid this Procedure?
Radiofrequency is not
recommended for patients with a cardiac pacemaker.
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