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Definition
Radiofrequency neurotomy is a procedure to reduce back and neck pain. It uses heat generated by radio waves to damage specific nerves and temporarily interfere with their ability to transmit pain signals.
In radiofrequency neurotomy, the radio waves are delivered to the targeted nerves via needles inserted through the skin above your spine. Imaging scans are used during radiofrequency neurotomy to help the doctor position the needles precisely.
Radiofrequency neurotomy works better in some people than in others. Tests may be required to determine if the nerves commonly targeted by radiofrequency neurotomy are the same nerves responsible for your pain.
Why it's done
Radiofrequency neurotomy is most commonly performed by doctors specializing in the treatment of pain. The goal is to temporarily reduce chronic pain in the back or neck that hasn't been adequately relieved by medications or physical therapy.
Risks
Common side effects include:
- Temporary weakness
- Temporary numbness
- Pain at the procedure site
Rarely, more-serious side effects occur, including:
- Long-term numbness
- Paralysis
- Dizziness
- Bowel and bladder incontinence
Some types of radiofrequency neurotomy apply heat to the targeted nerves in a more continuous manner, while other varieties of the procedure pulse the energy by turning it on and off rapidly.
Pulsed radiofrequency neurotomy appears to cause fewer side effects because it results in less damage to the area surrounding the targeted nerves. However, the pain-relieving effects also tend to fade more quickly.
How you prepare
To determine if you're a good candidate for radiofrequency neurotomy, your doctor may perform a test to see if the nerves commonly targeted by the procedure are the same nerves responsible for your pain.
This diagnostic test involves injecting a small amount of numbing medication into the precise spots where the radiofrequency needles will go. If your pain lessens, radiofrequency treatment at those spots will probably help you.
Prior to the actual radiofrequency neurotomy procedure, you should:
- Tell your doctor if you're taking blood thinners
- Arrange for someone to drive you home
- Eat and drink as usual
- Take your regular medicines as directed by your surgeon
What you can expect
During radiofrequency neurotomy
Radiofrequency neurotomy is an outpatient procedure, so you'll go home later that same day. The entire procedure usually takes about an hour.
You'll wear a hospital gown and lie on your stomach on an X-ray table. A special kind of X-ray machine, called a fluoroscope, will help the doctor position the radiofrequency needles precisely — so only the targeted nerve tissue will be affected.
An intravenous line will be placed in your arm or hand to deliver medication that will keep you comfortable during the procedure. Numbing medication will be injected into your skin before the radiofrequency needles are inserted.
After radiofrequency neurotomy
After the procedure, you'll be taken to another room to rest comfortably until you feel well enough to go home. You might notice some soreness in the area where the needles were inserted, but this usually goes away in a day or two.
Results
While radiofrequency neurotomy may not relieve all your back or neck pain, it usually reduces it by more than 50 percent. Factors that may affect results include:
- Whether the nerves targeted by the procedure are the same nerves responsible for your pain
- Presence of other medical or psychiatric illness that might affect your pain
Radiofrequency neurotomy is only a temporary remedy. The pain relief typically lasts between three and six months. However, the procedure can be repeated if necessary.
Last Updated: 2009-12-09
