Radiofrequency lesioning involves the use of alternating currents of radio waves generated by a specialized device that is harnessed to produce a small, localized, cylindrical area of heat that is capable of partial or complete destruction of nerves. Small needle-like electrodes are used to transform the energy made by the generated heat in a precisely controlled, safe, and accurate fashion. These electrodes are placed into the body under fluoroscopic or, in my case, CT guidance, so their tips contact specific nerves responsible for carrying pain signals, emanating from certain bodily structures, up to the spinal cord and eventually to the pain processing system in the brain. Correct electrode placement is verified by using the generator to elicit mild tingling sensations through stimulating the targeted nerves, while avoiding eliciting any muscle twitches from muscles controlled by the same nerves. The electrode tips are heated to a specific temperature (67 C° – 80 C°,) for a specified length of time (90-120 seconds), depending on the nerves and whether a complete or partial lesion is desired. In this case, lesioning means intentional creation of partial or total damage of a nerve for the treatment of pain.
In terms of pain control, radiofrequency lesions are used to treat painful conditions involving the spine or the nerves emanating from it, from the neck to the bottom of the spine. Potential pain generating targets which may respond exceedingly well to radiofrequency treatment include facets, discs, sacroiliac joints, painful scars, certain kinds of headaches, including those emanating from spinal structures in the neck (and including occipital neuralgia), certain kinds of facial pain, and certain conditions of complex regional pain syndrome, or RSD, as it was called previously.
Radiofrequency lesions are used not only to control pain but also cardiac rhythm disturbances, certain benign bone tumors, pre-cancerous lesions of the esophagus, and select cancerous tumors of the liver, bone, kidney, and lung.
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