Radiofrequency Ablation for back pain

Radiofrequency (RF) ablation is a minimally-invasive procedure that uses electrical current to destroy tissue. When the procedure is used to treat back pain, the nerves causing the pain are identified and damaged so that they can no longer transmit pain signals.

RF ablation is done using fluoroscopy, a type of moving, guided x-ray. The patient is sedated and a local anesthetic is used to numb the skin. Once the RF energy has been applied to the targeted nerves, the patient is allowed to go home the same day. The procedure takes between 30 and 90 minutes. It make take a week or two for the treated nerves to fully die.

About 70% of patients report pain relief after RF ablation. The nerves may regenerate, but pain relief generally lasts at least 6 to 12 months and may continue for years.

Kyphoplasty

Kyphoplasty is a minimally-invasive surgical technique used to treat compression fractures of the vertebrae. This type of surgery is called a vertebral augmentation. The goal is to stop the pain associated with the fracture, to stabilize the bone and to help restore the shape and height of the vertebrae.

Kyphoplasty may be performed to treat spinal compression fractures caused by osteoporosis.

During kyphoplasty, the surgeon makes a small incision in the back and inserts a tube. Using fluoroscopy (guided x-ray imaging), the tube is threaded into the middle of the damaged vertebrae through the fracture. A balloon is then inserted via the tube into the middle of the vertebrae. As the balloon is inflated, the area inside the vertebrae expands, helping to restore the height and shape of the vertebrae and to create a cavity inside. Next, the balloon is replaced by a cement-like material called polymethylmethacrylate (PMMA) that will harden and stabilize the area.

Kyphoplasty is similar to vertebroplasty, with the exception that a balloon is used to create space inside the vertebrae.

Vertebroplasty

Percutaneous vertebroplasty is a minimally-invasive surgical technique used to treat compression fractures of the vertebrae. Using fluoroscopy (guided x-ray), a tube is inserted into the damaged vertebrae via a small incision in the back. Once the tube is in position, a medical-grade acrylic bone cement is introduced to fill the spaces inside the bone. This cement serves a type of “internal cast” providing structure and stability to the fractured vertebra.

Patients go home the same day after the procedure. Vertebroplasty has excellent outcomes, with many patients experiencing at least a 90 percent reduction in pain within one or two days after the procedure. Recent research has indicated that pain relief from vertebral compression fractures treated by vertebroplasty can last up to almost three years.

Spinal Cord Stimulator

Spinal cord stimulation is a non-medicinal, non-surgical treatment for a variety of types of chronic pain, including neck pain, back pain, arm pain, and sciatica (leg pain). Many patients benefiting from spinal cord stimulation have had a previous failed back surgery.

The treatment works by implanting a device that delivers mild electrical impulses to nerves along the spinal column. These impulses “confuse” the nerves, serving to minimize or completely block the sensation of pain.

Patients undergo a weeklong trial period where leads are placed, but the device remains external. If pain relief is significant, the implant procedure can be scheduled. Once the procedure is complete, the patient receives a handheld device to adjust the amount of stimulation as needed.