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Nerve Ablation...

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Hi,
i've just found this forum & it's been interesting reading so far. I had a spinal fusion 15 years ago which has been a great success...Until now that is. I have now got severe pain in the lumbar area again. I had a facet joint injection 10 weeks ago which provided temporary relief. I have another flare up now & saw the specialist this morning. He is suggesting a nerve ablation around the worst facet joints, which are extremely inflamed. I will have to have another fusion but am trying to put it off for as long as possible. I had not heard of this procedure & would be keen to hear from anyone who has had it & the outcome as a result of it.
Thank you.
Ellen
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First Helper Chuzzy
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replied August 22nd, 2006
Experienced User
Hi Ellen
Hi ellen ~ :d

please check you pm (private messages)

shirl :d
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replied August 23rd, 2006
Ellen,

i think what you are referring to is rhizotomy. You could google the word rhizotomy and find information on this procedure.

Http://www.Google.Com/search?Sourceid=navc lient&ie=utf-8&rls=gglg,gglg:2006- 08,gglg:en&q=facet+rhizotomy

my first pain management doctor wanted to do a rhizotomy, but my oss did not think that it would help me.

You will find that some people think it is a real help to dissolving their pain, while others have seen no improvment. I would get other opinions from other pain management docs or from your spinal surgeon before allowing this procedure. I would also make certain that you have an experienced doctor that has done this procedure many times. There are serious consequences with this procedure if you are not in the hands of an experienced doc.

rhizotomy as described by spine universe:

http://spinetalk.Conforums.Com/index.Cgi?B oard=treatment&action=display&num= 1156348462&start=0

the facet joints are often the primary source of pain for many back pain sufferers. Facet joints are small joints located in pairs on the back of the spine that provide stability to the spine and allow the spine to move and be flexible.


Depending on where the problematic facet joints are located, they can cause pain in the mid-back, ribs, chest (thoracic facet joints), lower back, abdomen, buttocks, groin, or legs (lumbar facet joints), neck, shoulders, and even headaches (cervical facet joints).

Facet joint injections of steroid medications are often given to patients with this type of pain. The injections not only provide pain relief, they can also help the physician pinpoint exactly where the pain originates and can confirm or reject the facet joints as the source of the pain. For many patients, facet joint injections provide adequate relief. For others, however, the pain relief is too short-lived. For these patients, facet rhizotomy may be the answer.

what is facet rhizotomy?
the goal of a facet rhizotomy is to provide pain relief by "shutting off" the pain signals that the joints send to the brain. The pain relief experienced by most patients who have this procedure lasts months or even years.

how it is done
patients who are candidates for rhizotomy typically have undergone several facet joint injections to verify the source and exact location of their pain. Using a local anesthetic and x-ray guidance, a needle with an electrode at the tip is placed along side the small nerves to the facet joint. The electrode is then heated, with a technology called radiofrequency, to deaden these nerves that carry pain signals to the brain.

Serious complications with facet rhizotomies are rare. A new technique using pulsed radiofrequency does not actually burn the nerve, but appears to stun the nerve. This technique appears to be even safer than the regular radiofrequency technique, but does seem to have the drawback of not lasting quite as long. Some specialists (such as the author) prefer to use the pulsed technique in higher risk areas such as the neck.

The procedure takes about 30-60 minutes. Afterwards, patients are monitored for a short time before being released.


as you can see the nerve is not cut, it is burned. The surgeons use the term “shutting off “ the signal, but it does not mean cutting like with scissors.

this procedure can be done using two different methods. I was offered both and both are deemed effective.

One method is as described here and the other is by cryoablation. During this procedure cold is used and is described here:

cryoneurolysis/cryoablation: a technique that relieves pain by using cold to destroy nerve tissue.


radiofrequency nerve ablation is the term used when radio waves are generated and used to produce heat. By generating heat around a nerve, the nerves ability to transmit pain is destroyed, thus ablating the nerve.


Rhizotomy- surgical severance of spinal nerve roots to relieve pain or hypertension.

severance can be performed by cryoneurolysis/cryoablation and radiofrequency nerve ablation. These are two methods of deadening the nerve tissue and stopping the pain. The nerve is severed during these procedures.





http://spinetalk.Conforums.Com/index.Cgi
http://tarlovcspine.Conforums.Com/index.Cg i
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replied August 23rd, 2006
Experienced User
Hi ellen & gloria ~

here's a little information of the difference between radiofrequency nerve ablation (heat/burned) and rhizotomy (cutting).


radiofrequency nerve ablation -
facet joints are one source of back pain. Radiofrequency nerve ablation uses radio waves to produce heat directed at a specific facet joint nerve. The heat destroys the nerve and relieves pain.

rhizotomy - surgical procedure in which spinal nerve roots are cut; done (anterior roots) to relieve intractable pain or (posterior roots) to stop severe muscle spasms.

Ellen ~

please feel free to copy and paste your post on sab. :d

shirl :d
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replied July 7th, 2008
Facet rhizotomy
What are those serious complications you were refering too? I had the facet nerves burned off over a month ago and am in worse shape than i was before. I go back to the the doctor in the morning. I really think he may have screwed up or something. I had bad back pain before but i was still able to be pretty active but now, I can hardly walk some days. Embarassed
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replied July 7th, 2008
Experienced User
There is as much confusion about the terms by doctors that do not perform the procedures as with patients.
Rhizotomy means literally cutting the root. Long ago it was discovered cutting the anterior roots do not help pain and lead to permanent paralysis, therefore surgical transsection of nerve roots is no longer performed. The dorsal root ganglion, part of the sensory aspect of the nerve, is capable of being heated or pulsed with EM energy....therefore RF DRG thermal ablation (aka "rhizotomy") is possible and performed by a select few. The DRG provides sensation all the way down the leg (lumbar spine).
The RF ablation most physicians think of is called a RF medial branch neurotomy which is a heat lesion to the nerves supplying the facet joints only (localized in the back).
Many untrained physicians use the two terms inappropriately interchangeably. They are not the same procedure....
Many pain docs, thinking patients will not know the difference, may use the term "rhizotomy" when they really mean radiofrequency medial branch neurotomy.
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replied January 19th, 2012
Rhizotomy
Hi I'm a 2012 model asking similar questions. I was born with spina bifida and had I not had an operation to fix that with a initial myleogram that left myodil in my spine causing spinal arachnoiditis, I am sure I would not be in the mess I am today. I had my 6th spinal surgery in December 2011, it only worked for 3 weeks (my surgeon didn't think it would last long but he thought about 6 months giving me body a cahnce to build up its antibodies, and now I have to have a very big spinal op, undoing old fusions, screws, rods re-fusing and re-screwing. My surgeon couldn't do the big op in December as I havea disease called lupus thus at that time had virtually no antibodies to fight infection so my surgeon did a microdissectomy just cutting part of a disc and the gunk that had blown into my spinal column causing nreve root pain.I haven't sat down since April 26 2011 and have had to lie flat most of that time. I'm over this. When I can sit I can't walk very well due lumbar plexopathy due to Lupus and vasculitis, so have been using a wheelchair on and off for years. I'm ready to have it all cut and stay in my chair. However as a chronic pin counsellor I know that pain is the body's signal that something is wrong so it finds a way to get the pain message across. Would I be better off? probably not.
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replied February 9th, 2012
nerve ablation
Hello my name is erik and ive had 3 rounds of nerve ablation . the treatment last about 8 months and then its extremly painfull when the nerves grow back.It is also extremly painful when the nerves die.I have since moved to more natural ways to deal with the pain in my neck,c-5 , c-6.Physical therapy and pain meds, stretching and mind control.I would not recommend this procedure to anyone ever.It had me on my knees in extreme pain, even worse than the original pain i was trying to remidy.
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replied July 30th, 2012
Hell On Earth
My mom has been having nerve ablations in her back for several years, and it is a crap shoot. Either 1)It doesn't do much good 2) It helps for a month or two or 3) It inflames other surrounding nerves and she screams for two weeks when she sits down and gets up - screams like someone being murdered in those horror movies. I really wish I was exaggerating. That's what she is going through now. Screaming and screaming, losing control of her bladder, sobbing...I just want to commit suicide after having been with her today. My dad actually had to shut the windows yesterday because he was afraid one of the neighbors would call the cops thinking someone was being murdered. I have absolutely every understanding why people in chronic pain kill themselves. Either that, or their spouses mercy kill them and then shoot themselves too.

So....if you're considering spinal nerve ablation, remember this version of what could happen.

There is no God.
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replied September 14th, 2012
Hell on Earth, I am looking into this procedure and have been having so many thoughts as I do not want to be worse than I am now!! Several of these posts have pretty much convinced me that I am going to look at other options. The only reason I want to have something else done is becasue Iam taking 100 mg of morphine. My mom is amazed that it doesn't affect my life except to take pain away and make me functional. I am 51 years old and agree with your Mom at my worst times, you wonder if it's all worth the fight. There has to be a quality to life and continual horrific pain ain't it! MAn do I feel for her I trul do and for your Dad too. My wonderful husband would give anything to change things for me.
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replied August 10th, 2013
Hi Chuzzy, I'm 55 and also considering nerve root ablation. The problem is I also have fibromyalgia. My breast oncologist wouldn't take off my breast because she said I wouldn't be able to take the pain due to fibro. Now I'm reconsidering my decision to take the ablation procedure. Another problem, where do I look? Any surgeon will want to operate. I'm between a rock and a hard place and am so scared to go on living with this horrific pain. Its better now that I'm on morphine and percs, but who wants to live on those? And, what do you do when they no longer work? I can't stand the agony any longer.
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replied July 30th, 2012
Hell On Earth
My mom has been having nerve ablations in her back for several years, and it is a crap shoot. Either 1)It doesn't do much good 2) It helps for a month or two or 3) It inflames other surrounding nerves and she screams for two weeks when she sits down and gets up - screams like someone being murdered in those horror movies. I really wish I was exaggerating. That's what she is going through now. Screaming and screaming, losing control of her bladder, sobbing...I just want to commit suicide after having been with her today. My dad actually had to shut the windows yesterday because he was afraid one of the neighbors would call the cops thinking someone was being murdered. I have absolutely every understanding why people in chronic pain kill themselves. Either that, or their spouses mercy kill them and then shoot themselves too.

So....if you're considering spinal nerve ablation, remember this version of what could happen.

There is no God.
|
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