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A lumbar RFA is a procedure that uses radio waves to stop the lumbar medial branch nerve from transmitting pain signals from the injured facet joint to the brain. The procedure calls for a needle to be inserted through the skin and guided with X-ray to the correct site overlying the medial branch nerve. With the needle in position, the radiofrequency energy is applied to quiet nerve pain in this surgery or lumbar spine surgery. You can folow the basic guidelines given below : The day of the procedure: Avoid eating or drinking for six hours before your appointment time. If you have diabetes and take your insulin If you are taking pain medication, stop it six hours before your procedure. Other medications can be continued . You will need to have someone drive you home after the procedure. During the procedure: The procedure will take not more than 60 minutes, with you lying on your stomach. You will be given local anesthesia. If needed, sedative medication The needle is directed to its proper location using X-ray guidance. During the procedure, the doctor will ask you if you feel a tingling sensation or a muscle twitching. This helps to ensure if the electrode is in the proper place. The nerve is heated with radio waves until that nerve is unable to pass pain signals to the brain. After the procedure is done: A bandage may be placed You will be instructed to lie down for around 30 minutes. A nurse will check your blood pressure and pulse and discuss the discharge instructions with you. A responsible adult must drive you home. Why is this procedure done? Radiofrequency ablation/lesioning is a procedure used to provides a longer term pain relief rather than simple injections or nerve blocks. Many patients who are being considered for this procedure have already undergone simple injection techniques like Epidural Steroid Injection, Facet Joint Injection, Sympathetic Nerve Blocks, etc. The pain is reduced or eliminated from anywhere from a few months to up to 12 months. Does the procedure hurt? This procedure is no more painful than any other injection procedure . Patients are often given mild sedation , although sedation is not absolutely required. It is quite common for neck or back pain to increase for a few days or longer after the RFL procedure before it starts to improve. What should I do to prepare for my procedure? On the day of your injection, you should not have anything to eat or drink for at least eight (8) hours before your scheduled procedure. If you are scheduled to receive sedation during the procedure, you must have someone available to drive you home. If you usually take medication for high blood pressure or any kind of heart condition, it is very important that you take this medication at the usual time with a sip of water before your procedure. If you are taking any type of medication that can thin the blood and cause excessive bleeding, you should discuss with your doctors whether to discontinue this medication prior to the procedure. These anticoagulant meds are usually prescribed to protect a patient against stroke, heart attack, or other vascular occlusion event. Therefore the decision to discontinue one of these medications is not made by the pain management physician but rather by the primary care or specialty physician (cardiologist) who prescribes and manages that medication. Examples of medications that could promote surgical bleeding include Coumadin, Plavix, Aggrenox, Pletal, Ticlid, and Lovenox. Jasmine Bilimoria is a research writer and a contributor with Same Day Spine. Same Day Spine Institute specializes in minimally invasive treatments of the spine, using latest cutting edge technologies, such as stem cells, laser discectomies, artificial discs, spinal cord stimulators, minimally invasive fusions, etc for spinal treatments.
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