What is radiofrequency neurotomy?

Radiofrequency neurotomy is a nonsurgical procedure to help relieve chronic back pain. (Pain is described as chronic if it lasts for more than 12 weeks, even after treatment or medication.) It is a minimally invasive procedure that uses heat to destroy a nerve that is causing chronic pain. This procedure, also called radiofrequency ablation, is usually performed on an outpatient basis (the patient goes home the same day).

What happens during a radiofrequency neurotomy procedure?

During a radiofrequency neurotomy procedure:

  • The patient is placed on his or her stomach on a special X-ray table and the skin over the back is cleaned.
  • The correct areas for the injections are identified and the skin is marked.
  • The skin at the injection sites on the back is numbed.
  • The doctor then inserts a needle into the patient’s back and guides the needle, using a fluoroscopy (a live X-ray), to the nerve that is causing the pain.

Once the needle has reached the site where the nerve is typically located, the doctor will do a test to confirm that the needle is near the nerve and not near a motor or sensory nerve. When the sensory testing current passes through the needle and into the nerve, the patient will feel some pain in the back, which may move to the buttocks and down the back of the thigh. During the motor testing, the patient may feel some discomfort from back muscles that will twitch.

Once the correct needle position is confirmed, local anesthetic is injected through the needle to numb the area. Once the local anesthetic has had time to work, a small amount of electrical current is passed through the needle to generate localized heat. The heat kills the nerve and stops it from sending pain signals to the brain.

What are the advantages of radiofrequency neurotomy?

Radiofrequency neurotomy is a nonsurgical procedure. The recovery period is fairly short, and after a day or two of rest, the patient can usually resume regular activities.


Source: clevelandclinic