Radiofrequency Lesioning (RFL) Procedure of the Medial Branch Nerves (cervical, thoracic, lumbar)

Radiofrequency Lesioning (RFL) Procedure of the Medial Branch Nerves (cervical, thoracic, lumbar)

What is a radiogfrequency lesioning procedure?
Radiofrequency lesioning procedures are performed after completion of diagnostic medial branch block injections, which have confirmed the presence of mechanical pain, or pain with movement in certain positions. This injection is being done to try to more permanently relieve your mechanical pain. Generally, because of the way the nerves travel in the spinal column, you will have this procedure done at 2 or more levels during this procedure, or the same levels at which the medial branch blocks were done. This procedure heats up the nerves, which hopefully destroys the nerves and prevents them from transmitting painful impulses to your brain. The procedure is not necessarily permanent as the nerves can redevelop and your pain can return. There are some cases where patients receive excellent relief of their pain with the diagnostic medial branch block injection but do not get relief or adequate relief with this procedure. This procedure is often done in combination with or followed by specialized physical therapy treatments.

How is the procedure done?
You will be taken to the procedure area and positioned on a special x-ray table. You will be hooked to monitoring equipment. Your skin will be sterilized with Betadine or a similar solution and the needle insertion site will be numbed with local anesthesia. Special needles will be inserted into the specific area that your physician has determined is appropriate for the location of your pain. The needle is then hooked to a special machine, which heats up the nerve at each level. It takes approximately 1-2 minutes at each level, and more than one lesion may be made at each level, so depending on how many levels are done you might have to lie still for some time.

Because this procedure is more involved than the diagnostic medial branch block injections, you may take longer to get over this procedure. You may have increased pain for 2-4 weeks after the procedure, which can be treated with medications, and you should think of your recovery being more like healing from an incision.

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