Radiofrequency Medical Branch Ablation

Why was this Procedure Performed?

This procedure is done to mitigate the transmission of pain signals from facet joints and can assist in the treatment of the pain. The facet joints are small joints throughout the spine that can become arthritic and painful for a variety of reasons. The medial branches are nerves that innervate or provide sensation to the facet joints. The facet joints of the spine can cause back and radiating pain in up to 20% of patients. By ablating the nerve with radiofrequency energy, it is the hope that its transmission of painful stimuli can be attenuated for a prolonged period of time. This time period is generally from 6-24 months.

How is the Procedure Performed?

You will usually have an intravenous line (IV) inserted before the procedure. A small insulated needle will be inserted in your back near the spine. The needle will always be inserted under X-ray as this helps guide the needle to the exact location. When the needle is in the correct position, test stimulations at various frequencies will be used to ascertain correct position. Local anesthetic and steroid will then be injected to temporarily "turn off" the nerve or the joint and also to decrease inflammation. The nerve will then have one or more “lesions” created. After the procedure, the nurses in the recovery room will watch you closely.

What can you expect after the Procedure?

After the procedure is performed, you may or may not notice immediate pain relief. The local anesthetic will numb the joint for about 2-8 hours depending on the type of local anesthetic used. Rarely this procedure may cause some numbness and weakness of your extremity from the local anesthetic. For this reason, and because of the sedation, you will need someone to drive you home. If your leg is numb from the procedure, you will need to avoid any unassisted walking, climbing or exertion until the numbness and weakness wears off.

What if you have worrisome side effects or other concerns?

You may experience a small amount of bruising, bleeding or swelling at the injection site. It is best to apply ice compresses in the first 24 hours followed by heat after 24 hours in short durations, usually 20 minutes at a time. Please continue regular medications. If you are experiencing other difficulties or side effects please call our office at 502-PAIN (7246) so that we may recommend further action or please go to the nearest emergency room for evaluation.