In this procedure, a heat lesion is created on certain nerves with the goal of interrupting the pain signals to the brain, thus eliminating pain.
The terms radiofrequency ablation and radiofrequency neurotomy are used interchangeably. Both terms refer to a procedure that destroys the functionality of the nerve using radiofrequency energy.
There are two primary types of radiofrequency ablation:
- A medial branch neurotomy (ablation) affects the nerves carrying pain from the facet joints
- A lateral branch neurotomy (ablation) affects nerves that carry pain from the sacroiliac joints.
These medial or lateral branch nerves do not control any muscles or sensation in the arms or legs, so a heat lesion poses little danger of negatively affecting those areas. The medial branch nerves do control small muscles in the neck and mid or low back, but loss of these nerves has not proved harmful.
After your screening test you will talk with your doctor about your results. If you and your doctor decide to use a neurostimulator to treat your chronic pain, you will need a surgery to implant the system. This procedure is most often performed in a hospital or surgery center on an outpatient basis. You may even be able to return home on the same day as your procedure. However, some people stay overnight.
During the surgical procedure, the doctor:
- Makes a small incision (about 2 to 4 inches long) on your back and uses a needle to place the leads (medical wires) that deliver the stimulation into the epidural space of your spinal cord
- Makes a second incision (also about 2 to 4 inches long) and creates a pocket under the skin that is large enough to hold the neurostimulator
- Connects the leads to the neurostimulator
Once the leads and neurostimulator are in position, the doctor closes the incisions and completes the surgery. The length of your hospital stay will vary depending on your doctor’s preference and hospital procedures.
The neurostimulation implant is surgically placed under the skin. Surgical complications are possible and may include infection, pain at the site of surgery, and bleeding into the epidural space. Once the neurostimulation system is implanted, device complications may occur and include corrective surgery, jolting, leads breaking, and movement of the leads within the epidural space which may require reprogramming or surgical replacement of the leads. These events may result in uncomfortable stimulation or loss of therapy.