Anyone familiar with radiofrequency neurotomy?

Cathy · #1 (**permalink**) 03-05-2007, 01:14 AM

Has anyone out there had a radiofrequency neurotomy? Evidently there are two diognostic procedures that have to be done first (for which I have already had one) where in they stick three needles one inch apart down your spine to put a drop of numbing solution on the nerve root. It was very painful because it is done without sedation. Needless to say, I am not looking forward to the second one. After the next one is done, they will go back in with a rod looking device to burn the nerve. I would much rather forgo this and hurry up with the ADR. Unfortunately work comp has their own opinion as to how my medical treatment should go.
Any insight on this would be greatly appreciated.
Cathy

mmglobal · #2 (**permalink**) 03-06-2007, 02:48 AM

Cathy, I have no personal experience with rhizotomy, but have several clients that have had them. Some with great results, some very disappointing. Like all things spine.... it all depends on your pain generators. If your facets are painful, then a sucessful rhizo should give several months relief. Determining which are painful is not always easy. We should talk soon.

mark

Michelle · #3 (**permalink**) 03-07-2007, 04:58 AM

I'm waiting for insurance authorization on this very procedure. The diagnostic injections are not fun, are they? The worst part for me was the week of increased pain after them. Did you have good pain control for the first few hours after the injection? That's a good indication that the facets are the problem. The good news is that if the facets are not a problem, that's a good sign that an ADR will significantly help. I hope you get some relief!

Cathy · #4 (**permalink**) 03-09-2007, 01:31 PM

Hey Michelle,
The diognostic tests were not fun at all to say the least. I did get a small amount of relief. I guess they went in on three different levels because they put needles, three in a row, about an inch apart down my spine. I got about as much relief as if I took one half of a dose of meds (which do very little to begin with). However, at this point I will take any amount of pain relief until I can get my ADR. Hope all goes well with yours.
Have a wonderful weekend,
Cathy

Michelle · #5 (**permalink**) 03-10-2007, 05:55 AM

Half a painkiller huh? Are they thinking of going ahead with the neurotomy for you? Doesn't sound like it'd do enough to be worth it IMHO. I was there before my ADR, and didn't mess with it because for me, taking the pain from 9 to 8.5 wasn't worth the hassle. But there were times I would've taken .02 points of relief. I hope you get some relief while waiting-talk about feeling like forever, huh?? Good luck, I wish for the best for you, and expect it!!

tisury · #6 (**permalink**) 03-11-2007, 06:48 PM

I had radiofrequency neurotomies done from L2 to L5. Unfortunetely, it didn't do a thing for me. The diagnostic injections they did (facet joint blocks and medial branch blocks) gave me brief, but remarkable relief. The actual rhizotomies did nothing to relieve any pain. The feeling is that the injections "leaked" out and coated the nerves, but that the facets were not the actual problem. I don't understand this as well as I would like to. If they are zapping the nerve, why wouldn't it work if it isn't a facet problem?
On the plus side though, I have talked with people who have gotten remarkable relief from the neurotomies - sometimes for as long as a year. They say they knew when the nerves were growing back cause their old pain started to return, and then they would go get zapped again. My understanding is that it is a very safe procedure and will not burn any bridges for further treatment if it doesn't work. That argument made it worth a try in my books.

KamH. · #7 (**permalink**) 03-13-2007, 12:14 AM

I have had a few over the yrs and yes the injections are as the prior poster said ,they can leak into the area adjacent ;so they cannot be real sure since it works due to numbing surrounding tissue an/or nerves . I had some relief for a few months ,maybe even up to 6 months but nerves do regenerate . I opted for this when I felt to many ESI 's were not good . I honestly have not had this done now in a few yrs. I can see many new options are out there for spinal issues and that is wonderfu ! I have a 3 level fusion (cervical since 98) and have alot more issues on down spine now ..which was expected ! I am trying to deal with my spine now in a minimal invasive way (if possible) I hope you get pain relief ! I was told by a pain dr a few yrs back that 'pulsing' was not beneficial and a waste of time ...meaning burn em out do not play around I guess .. I woke up an dr said you will be fine I pulsed everything !! I was disappointed ! since I had this done more then one time ... in comparison I would agree do not pulse ..the drs will tell less pain after pulsing; but ya want it to work also !
any way I wish ya the best . so much info out there and I have not done for a few yrs now . best to ya Kam

tisury · #8 (**permalink**) 03-13-2007, 12:25 AM

This is an amendment to my previous post so that you didn't miss it. Apparently my brain was too tired to think straight and my spine has had way too many procedures to keep track of. The part about insurance not covering it.............that wasn't the neurotomies that they refused to cover, they did cover that in full without a battle. It was the nucleoplasty procedure that I had which the insurance refused to cover because they considering it experimental. Sorry about the confusion.

Cathy · #9 (**permalink**) 03-14-2007, 11:17 PM

Well, since it seems that since the procedure won't jepordize any further treatment, I am going to have the second diognostic test done. Any little bit of relief would be great. Seeings how work comp doesn't seem to be in any great rush to schedule my ADR. Thanks for ya'lls responces.

mmglobal · #10 (**permalink**) 03-18-2007, 05:56 AM

Cathy, when is your rhizotomy scheduled? If your diagnostic blocks were not determinative, then the rhizo may be something of a 'hail mary'. However, if you are ultimately going to have ADR, you need to ask the doctor if ablating the nerves and tissues surrounding the nerves to the facets may increase the risk of future facet degeneration. Let's talk next week.

Mark

Cathy · #11 (**permalink**) 03-21-2007, 02:36 PM

Hey Mark,
My second diagnostic test for my rhizotomy is this Friday. I was sick when the initial second test was scheduled and had to cancel. My pain management doctor left for vacation for six weeks shortly after that appointment was suppose to take place. So I asked if I could wait to do the second test until he came back (which I hoped would give enough time for the ADR to be scheduled). But the pain management office said that work comp said that I had to proceed using another one of their doctors. Tomorrow is when it is set for. I'm going to try to get a hold of Dr. Garcia's office to ask him what you suggested. I'm not sure if I told you that when my surgeon, Dr. Gaines, wrote the recommendation to work comp. for the ADR he also tried to recommend Dr. Garcia, but they said that he can't choose the doctor. Therefore, I sent his recommendation to my attorney and he sent a request for me to have an appt. with Dr. Garcia to the work comp. attorney. I haven't heard a response yet. I'll let you know what Dr. Garcia's office says.
Hope all is well with you and yours,
Cathy