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Old 09-16-2006, 01:15 PM #1
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RFA? Radio Frequency Ablation?? If so, I had an RFA in April on C3/4 facet joints.

My results of the procedure were not good, I ended up with Occipital Neuralgia and associated pain from that when an adjoining nerve branch was only partially lesioned. (fried). However, it did appear to relieve pain in my original area that was caused by the C3/4 nerve roots, but C2 nerve branch was also paritally fried, thus the new pain and neuralgia....

I was told my by PM Doctor yesterday that if I required the procedure in my Lumbar or Thoracic area that the chance of the complication I had was only around 1%, he never said what it was for the cervical area but I believe I read somewhere in the 5-10% range, so lucky me.

I can neither recommend it nor not recommend it, you have to find out as much as you can from others and of course each person has different circumstances involving what is wrong with them and how to treat it. Of course, anything somewhat conservative in treating for relief of pain is better than going under the knife in my opinion.

Sorry, cannot be of much more help, but if your RFA is what I have had done, Goggle "Radio Frequency Ablation" and you should find a bit of information about it.

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Old 09-16-2006, 04:34 PM #2
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Linda, I was going to have an RFA done at L4-L5 bilaterally, but my PM said that the test to see if it (RFA) would work, was to do facet joint injections, to see if the injections relieved the pain. He said you get two sets of the injections (if the 1st one works). I did them, they did help, but then I chickened out on the procedure. I googled it, and found the success rate fairly low (I think it was about 33%, but that is a guess). Plus, I asked my OS about it, and he said he had patients come back to him where they did not work. But he also said, it doesn't mean that some of his patients had them, they worked, and did not come back to him. He did not advise me, because I had already decided I really did not want it.
There was a lot of info on BT, and I hope you can find the info you need.

I am 47, and my PM didn't mention a thing about age and long-term effects. So, I think even the doctors do not have the same opinions. Maybe a second opinion? Good luck, and I hope others come through with their experiences. I know there were alot on BT that they worked for, and alot that they didn't work for (I posted the question there, myself).
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Old 09-17-2006, 02:48 AM #3
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My 2 cents for what its worth. I had an RF done at c2-c3 I think, somewhere in the cervical area. I did have the facet injections and they did help but for some reason the RF did not. I experienced more pain and soreness for about a month or so and I had hoped that once that leveled off I would get some relief but I didn't. I would say read all you can about it and hopefully others will come who have had a positive experience than you just have to weigh your options. Good luck to ya...Sue
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Old 09-21-2006, 03:57 PM #4
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Well, I had RFA today. I just got home a few minutes ago. It was kind of tough, and I can stand a lot of pain. My back is still numb so I don't know if it did any good. Same old ice, rest and no bath for 24. I just hope it was worth it. I am having my right side done in 2 weeks. Gonna try some ice. Later Linda
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Old 09-22-2006, 01:41 PM #5
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Linda,

It is nice to see you back...I was going to post some information on it, but I see you already had it done...If you really want or need more info just post...I hope you are comfortable and resting well...

I personally decided it was not for me...but that was me and we are all different...
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4/06 - Lumbar Fusion - L1, L2, L3, L4, L5, S1
Anterior with cages and Posterior with rods and screws.

8/17/05 - Cervical Fusion - C4-5, 5-6, 6-7 - Anterior and Posterior Fusion with plate in front and rods and screws in the rear - Corpectomy at C-4 and C-5 and microdisectomy at C6-7.

1/4/05 - Lumbar Laminectomy -L3, L4, L5, S1, S2 Obliteration of Tarlov Cyst at S2. Failed surgery!
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Old 09-22-2006, 02:35 PM #6
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Gloria-I would appreciate any information that you have on the subject of RFA. I am not sure it was the right choice that I made, but I had to do something. I had too much pain to enjoy anything. I had injections but they never lasted more than a day or two at the most. I really have never had much luck with pain meds either. Surgery seems to be out of the question for the moment at least. The pain has made me feel like I am on the edge. I don't know how else to describe it. It seems like I can not deal with anything right now. -Linda
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Old 09-22-2006, 04:47 PM #7
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(((( Linda ))))

I hope that your pain lessens. I can't even imagine how it feels to have the RF'ing done unilaterally; each time I've had it done, it's been bilateral, multi-level. The second through about fourth day following having, generally, been the roughest for me.
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Old 09-22-2006, 04:48 PM #8
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Linda,

I was given the option of Rhizotomy by Hopkins after my laminectomy failed. I went back to Penn and the docs at Penn told me they thought that was bad medicine for me...Hershey was also willing to try it. After I read about it I decided it was not for me...I will see if I can find some research about it as well...We did have some great infor on the old BT board.

Facet Rhizotomy
Steven Richeimer, M.D.
Director
USC Pain Management, USC Medical Center
Los Angeles, CA, USA

Ms. Mary Claire Walsh
SpineUniverse Staff Writer

http://www.spineuniverse.com/display...rticle200.html
The facet joints are often the primary source of pain for many back pain sufferers. Facet joints are small joints located in pairs on the back of the spine that provide stability to the spine and allow the spine to move and be flexible.






Depending on where the problematic facet joints are located, they can cause pain in the mid-back, ribs, chest (thoracic facet joints), lower back, abdomen, buttocks, groin, or legs (lumbar facet joints), neck, shoulders, and even headaches (cervical facet joints).

Facet joint injections of steroid medications are often given to patients with this type of pain. The injections not only provide pain relief, they can also help the physician pinpoint exactly where the pain originates and can confirm or reject the facet joints as the source of the pain. For many patients, facet joint injections provide adequate relief. For others, however, the pain relief is too short-lived. For these patients, facet rhizotomy may be the answer.

What is facet rhizotomy?
The goal of a facet rhizotomy is to provide pain relief by "shutting off" the pain signals that the joints send to the brain. The pain relief experienced by most patients who have this procedure lasts months or even years.

How it is done
Patients who are candidates for rhizotomy typically have undergone several facet joint injections to verify the source and exact location of their pain. Using a local anesthetic and x-ray guidance, a needle with an electrode at the tip is placed along side the small nerves to the facet joint. The electrode is then heated, with a technology called radiofrequency, to deaden these nerves that carry pain signals to the brain.

Serious complications with facet rhizotomies are rare. A new technique using pulsed radiofrequency does not actually burn the nerve, but appears to stun the nerve. This technique appears to be even safer than the regular radiofrequency technique, but does seem to have the drawback of not lasting quite as long. Some specialists (such as the author) prefer to use the pulsed technique in higher risk areas such as the neck.

The procedure takes about 30-60 minutes. Afterwards, patients are monitored for a short time before being released.

What to expect
Very little preparation is required for a facet rhizotomy procedure:

•Your physician will give you detailed instructions about whether you can eat before the procedure.

•In most cases, you can continue to take your usual medications before a rhizotomy. However, make sure you discuss what medications you use with your physician before the procedure.

•Since a rhizotomy requires the use of a local anesthetic, you may need someone to drive you home after the procedure.

Once you are ready, you will be given an IV with a mild sedative to keep you comfortable but awake during the procedure. A local anesthetic will be used to numb the area where the injection is to be done. An x-ray machine is then used to guide the exact placement of the needle/electrode. Once the needle is injected, a mild electrical current is used to stimulate the nerve and confirm its exact location. You may feel slight pressure or tingling during this part of the procedure. Then the electrode is heated to deaden the sensory nerves. When the procedure is completed, the needle is removed and the injection site is bandaged.

After the procedure
Some initial discomfort may be experienced immediately after the procedure, including bruising, soreness, or swelling at the injection site. However, most patients are able to return to work and their normal daily activities the following day.

Also, your back may be sore for a few days after the procedure. This is procedure-related pain and can be treated successfully using ice packs or over-the-counter pain medications. After a few days, you should begin to notice an improvement in your usual pain and can expect continued improvement over the next several weeks.

Serious complications are rare, however contact your physician if you experience any of the following:

•Prolonged pain at the injection site
• Fever
• Chills
• Dizziness
• Weakness
• Numbness that lasts more than 2-3 hours
• Bleeding or drainage at the injection site

Facet joint rhizotomy or medial branch neurotomy can effectively treat low back pain emanating from painful facet joints unresponsive to steroid injections. This efficacy hinges on the technical skill of the physician performing the procedure. Each facet joint is supplied by two small nerves so two needles must be placed to treat one joint. Findings of a recent surgical anatomical study have confirmed the accurate course of these nerves targeted in this procedure providing more compelling evidence for proper needle placement. Safe needle placement is critical in avoiding complications related to inadvertent injury to nearby structures leading to increased back or new leg pain. Although symptom reduction may be appreciated within a few days, facet joint rhizotomy should not be considered unsuccessful unless no pain relief occurs by 6 weeks after the procedure. Evidence shows that 60% of properly selected patients experience at least a 90% reduction of their low back pain that is sustained for 12 months, and 87% obtain at least 60% relief. If low back pain symptoms return over time, repeating the procedure can restore similar pain relief. However, one must keep in mind that these results are attainable when completed by well-trained interventional spine specialists experienced in executing these procedures.
__________________
4/06 - Lumbar Fusion - L1, L2, L3, L4, L5, S1
Anterior with cages and Posterior with rods and screws.

8/17/05 - Cervical Fusion - C4-5, 5-6, 6-7 - Anterior and Posterior Fusion with plate in front and rods and screws in the rear - Corpectomy at C-4 and C-5 and microdisectomy at C6-7.

1/4/05 - Lumbar Laminectomy -L3, L4, L5, S1, S2 Obliteration of Tarlov Cyst at S2. Failed surgery!

Last edited by GJZH; 09-22-2006 at 05:05 PM.
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Old 09-22-2006, 04:55 PM #9
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GJZH I might be confused but it seems that there appears to be at least 3 names for what I believe is the same procedure?

RF Lesioning
RF Abalation
Rhizotomy

As I mentioned earlier in this thread, I was one of the unlucky ones to have complications after the procedure. It is over 5 months since my RF of C3/4 facet joints and I still have the numbness, neuralgia and new painful spots I did not have before the procedure. (Thanks to paritally hitting C2 nerve branch)

On my copy of the "Report of Operation" The technical name listed is: Radiofrequency rhizotomies Right C3/4 medial branches with fluoroscopic guidance. Yet, my Doctor first called in verball an RF Abalation and the written literature I was given describing the process it was called an RF Lesioning....

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