Radiofrequency Ablation
 

I'm supposed to have a lumbar radiofrequency Ablation (RFA) done on
10/4. I have information on the procedure, so I know what it is and
how it works. What I'd like to know is, has anyone else had this done?
Did it work for you? Did the pain return when the nerves grew back?

Thanks!:)

We just discussed this yesterday in Linda's thread ....

http://forums.braintalk2.org/showthread.php?t=906

I'm reading the thread right now. Thanks!:)

Braindrain,

I think because we discussed this so negatively yesterday...I feel compelled to tell you that I was reading another board yesterday and this person reports she did have a positive experience with this procedure. Many people do report positive experiences with this procedure, but it does have to be repeated and I think as many of us pointed out, we just do not know the long term side effects since this procedure was originally used on cancer patients and their illness was terminal...

Read on though...I do not know if I can post a link to another board, but it is a spinal board...

http://www.backpainsupportgroup.com/...c;f=1;t=009906

I clicked on the link, but I can't read the message because I'm not a
registered member of that board.:o

Rhyzolysis success
 

Hi there, I've just found these boards and would like to share my positive result from RF.

My C spine has been done twice and I am currently booked for a third trip. Pain relief (for me) lasted approx a year. I had suffered daily cervicogenic headache, come migraine, due to various problems above and below my two level (failed) fusion. I couldn't believe how wonderful I felt following my RF procedure....considering I'd gone there with few expectations that anything would work. I was rock bottom when it was finally offered, and I can tell you that I would have accepted whatever they offered in hope of ridding myself of sickening pain. I felt so elated when I realised I was feeling a bit normal again. It did take about three weeks for procedure aches to settle down.....and you must expect the initial pain associated to the surgical trauma. In my opinion they were mild compared to the daily grind of head/neck pain I knew.

It's my experience that the nerve "did grow back" after a year or so. Perhaps regenerated is a better term to use. My OSS told me to expect anything from 8 months to 18 months and I feel delighted to have made it to a year. I am most confident in having repeat RF's because I know that my OSS is very experienced, and practiced, in the art of this procedure. I do believe that success is determined by skill of the practitioner....and in the determination to help you. It also requires a positive block to qualify in the first instance as a candidate. If you have the opportunity to go ahead. Take it. I gather you know It's to do with facet joint rather than disc matter.

I wish you the very best ahead.

I'm sure there will be some post surgical pain, but I'm used to that (I've
had a couple of brain surgeries in the past 11 years). What I'm really
hoping for is better mobility. I know it won't be perfect, but I'd prefer
a cane to this walker I'm using at the moment.

Yes, I know about the facet joints, because the doctor gave me an
information sheet about the procedure and it specifically mentions
the facet joints. My discs are degenerating anyway, so there's
nothing they can do about that.:(

Okay, I've got a silly question: after the procedure and the post-op
pain wore off, were you able to sit anywhere comfortably? I haven't
been able to sit in the kitchen to eat for over a year! The old chairs
were wooden, with cushions and when I got up from the table, if I
didn't have my cane right next to me, I'd fall on the floor because
my legs were so stiff from sitting on the wooden chair. The same
thing with metal chairs or cement benches. To this day, I eat all
my meals in my room because I can't use the stools that are in the
kitchen now. Is there any chance that this will improve after the
procedure?

Hi, my name is Linda and I had this procedure done also in my lumbar region last Thursday. I had no IV, nothing to relax, I went into my doctors office and bam! I was on his table almost an hour. I have to admit too, that it was painful and also kind of traumatic. I really have never had anything done to me when I was awake that even compares to it. Afterwards I was quite sore. Now this morning, I thought I could feel the old pain. This afternoon, I could not notice it as much, but then again, I had a terrible day. I am not real far along in the what comes after of this, but I will have to see what happens in the next few weeks. For me, the jury is still out. I am too new to this to say if it is better. For what it is worth-Linda

I had a 3 level Facet-joint Rhizotomy done in December 05 and my pain has just come back this month. I would say I had a great result and would get it done again. I had it done as a day-procedure in hospital and was knocked-out (heavily sedated but could apparently talk to the Docs.) for the procedure. I wouldnt do it unsedated. I was sore/achey for the first day or two afterwards but the relief I got was fabulous. Now thats its worn-off I can really feel the difference.

Well, I know that I may feel sore for a few days after the procedure, but
I'm hoping that it doesn't last too long.

I'm confused about the anesthetic part of the procedure. According to
the paper I have, it only mentions a local anesthetic, but lindy said she
didn't get anything and tonia said they knocked her out. Does this all
depend on the doctor doing the procedure?

tonia, what was your mobility like after the procedure? Were you able
to move around comfortably? Did you have any stiffness in your legs?
Like I said, I know I probably won't be 100% better, but I'd like to be
able to get around with a quad cane, instead of this bulky walker I'm
using at the moment.

Thanks, ladies!:)

I was knocked out for my RFA, I remember the X-Ray type arm contraption being placed near me and next thing I remember is waking up in the recovery room...

Jyes

That's what I'm hoping for. I don't want to see, hear, or feel what the
doctors are doing during the procedure.

Gina,

I've also been "under" during mine; Versed was used and it wipes out "memory" of just about everything. I think it took several months before the nerves regenerated, and, eventually, pain returned. The "upside" to RF is that it can be repeated.

I know that the nerves will regenerate and the procedure will have to
be repeated, but I'm really hoping that it takes a long time before that
happens.

Here's the part that worries me: the doctor is going to do the right
side, first (it's the left side giving me trouble) and I'm supposed to keep a
"pain diary" for a week. If I have any decrease in pain, then he'll do
the left side. If the pain doesn't change, then he's going to try something
else-I have no idea what.

Does this make any sense to you?:confused:

Gina- I think that I may have mislead you. When I said that I had nothing for pain or to relax me, it wasn't quite right. I had many shots of navacaine. My PCP could not believe that he gave nothing to relax me-Linda:eek:

Okay, gotcha!:) That's sort of what I'm afraid of-that the anesthetic
won't work and I'll feel everything during the procedure. And, the paper
I was originally given only mentions a local anesthetic. I really don't
want to see what they're doing, y'know?:eek:

I had full mobility after the RFA., it really worked well for me. I didnt use a walker or cane before this though, I just had really annoying back-pain from DDD.

I was sedated (asleep) but able to talk during the procedure cos they asked me questions apparently and I also complained about a sore leg during the RFA .,I dont remember any of it though 'cos of the drugs they gave me.

I dont know why they would only do one side, my Doc decided to do 3 levels after initially only going to do 1 level. I hope you get the same drugs I got, ask them to give you more information, I really think you dont want to be awake.

I'm not sure why they'd do one side at a time, either, but the way I
understand it is that they're going to do the right side first and then
I have to keep a "pain diary" for a week. If there's any improvement
in the pain, then they'll do the left side. What's really confusing me
is why they would start with the right side, when it's the left side I'm
having trouble with the most.:confused:

expectations
 

If they start with your right side and your problem is left....it would surprise me to see you gain adequate relief. However, I trust they have a plan for a reason.

RF "requires a positive block"....it's a nerve block carried out prior to going ahead with RF. What sort of relief did you get with your diagnostic block? This will/should indicate the type of relief expected from your RF. I've had top and bottom RF's. My C spine worked like a dream. My lumbar RF relieved me of local (mechanical) low back pain....but did nothing for sciatic pain. I've had long standing lumbar disc protrusions plus facet joint involvement, a common type of problem amongst many of us here. My OSS has booked me for another shot at L spine RF but also discussed the likely need for nerve sheath injection (ESI).....if RF doesn't address my pain adequately. I'm expecting him to do right and left side of L4-5, S1 as he did before. I understand that a number of levels can be done at the one sitting depending on need.

I do believe you should call and confirm the type of sedation you will get. My OSS will never do RF under any condition other than neurolept anaesthetic (you know it as versed). He said it is essential to have me as still as possible and is the reason for neurolept anaesthetic in a day surgery setting. Neurolept (versed) provides an amnesiac state where you can participate but won't remember what has been done. In some circumstances the patient might be too lightly sedated but the anaesthetist should respond with a top-up.....reason why a patient reports awareness of parts of their procedure. It's also done under fluoroscopy guidance for safety and accuracy.

I've never had problems with mobility on wakening in recovery....even after lumbar spine treatment. My walking is "a bit" wobbly at the best of times but I've not yet required a stick or other aids. I do experience quite a bit of muscle twitching after my RF's are performed.....usually settles after a month or so. I put this down to nerve that feeds muscle having been stimulated during the procedure.....it doesn't bother me. I think that post procedure pain would vary person to person depending on individual tolerance. It's not until the day after that I feel sore and bruised....nothing that my usual pain meds won't cover....might dip into prescribed stronger med if needed. I'm instructed to take it easy during the first week of recovery at home. As I said in previous post.....at approx week three I was able to determine the degree of relief I'd gained.

It sounds to me as if your doctor has set a similar plan to mine. Attempt RF, and if all fails give ESI a shot. ESI (epidural steriod injection) is the better choice for disc matter.....sciatic leg pain. Where do you feel your pain the most? I find that "constant" sciatic pain is my worst but having RF for facets (the local back pain stuff) then ESI to knock-off sciatica. Well, maybe there's hope for total relief.

I don't understand a doctor not offering neurolept anaesthetic these days. It's prettywell the norm for this type of procedure.

I've had the lidoderm patches for my lower back, and they also tried to
put me on hydrocodone. Unfortunately, the pill blocked up my bowels
so bad that the lower end of my shunt (for hydrocephalus) was blocked.
I ended up in the hospital with a shunt malfunction. As soon as the
blockage was cleared, my symptoms went away. I ended up taking
the patches again, and that's when the subject came up about RFA.

I haven't been given a nerve block of any kind. The doctor never
mentioned that I needed one before the RFA.:confused:

He did say that if the RF didn't work, we'd have to try something
else, but he didn't say what it might be. I thought maybe he was
waiting to see if the RF worked, first, before making any other
suggestions.

As far as the anesthetic or lack of it, the information sheet I was
given is dated 2005. Maybe that explains the difference?:confused:

Interesting that you didnt have/get any diagnostic nerve-blocks...

As far as I know they are given before they do an RFA to see if an RFA would be of any use...if you have a sucessful nerve-block they can usually go ahead with an RFA.

I say ask lots of questions and be sure this is what you want to pay for, you dont want to pay for something that isnt suited to your situation.

How far in advance of the procedure are the nerve blocks given? I'm
supposed to have the procedure on the 4th of this month.

I'll be asking the doctor a lot of questions, trust me!:)

My PM scheduled the RF procedure just shy of a month after my facet joint block. Seems to me, that if the block works, for temporarily blocking the pain, then it is considered successful and the PM or whoever will then schedule the RF if you consent.

I had my block done in blocks done in March and a few weeks later the RF procedure was done...

Jyes

Yeah, I had mine a month or so before my RFA...

basically you try out the 'numbing/deadening' of those nerves with a temporary fix., then after you have tried it and liked the effect you are set to go ahead with the more complex and hopefully longer-lasting RFA...I would think its silly to get an RFA if you havent had the area tested first to see if you may benefit from it. I guess it is possible that your scans show you have dodgy facet-joints and its obvious to the Doc. that this is your pain generator.

not so good rfa
 

I have rsd for two years now i have had all the shots wraps'meds.'finally down to rfa the first one took 2 hours with ending when the electric bed broke nithing was done but alot of pain in my back with stingers all the way down to my toes went back for asecond one another 2hours with poking and proding to whichc the outcome was the same as the first one the doctor said i couldn't be sedated on either one of them now i am schuelded for a third one third times a charm they say this time the doc says he will give me something to relax i am so done with this procedure!!!! i have to do these because this is a workers comp injury thanks for listening to my problems i am glad i found this sight

:mad:

I would be mad as hell if I had to endure procedures I didn't want to undergo, and it were painful and not helping. Adjusters are not medical doctors. And if my doctor would try to force it on me, I would be very upset, but I would have to think about that if my doctor said I needed it.

Sorry you had to go through with that. :hug: