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Anyone Have Good Results with RF Rhizotomy??
Avatar_dr_m_tn
I had low back pain for many years. One of the pain generators was a congenital Spondy at L5 S1 and I was very lucky to have that successfully corrected surgically by an outstanding surgeon in Denver, Dr. George Frey.  He used a micro approach, i have an inch incision and fused quickly with no complications.  

However, the years of instability and degenerative disc disease lumbar spine have caused a very common secondary problem - Facet Arthritis.  These tiny joints on the back side of each vertebral segment become terribly irritated from unstable spinal column support over the years.  The result is Facet Arthritis.  The "angry" joints can be seen on MRI or CT scan.  Once this progresses to moderate or severe it is a very serious pain generator.  Well, I'm there.  

Just FYI, for someone who have never felt or properly experienced this pain, mine is diffuse low lumbar and not very location specific.  If I had to describe it (not knowing what it was) I'd call it severe muscle spasms.  However it has taken me years and meds and injections to realize for myself this is facet pain.  It has progressed to the point where I must do something.  I am taking far too many meds, too immobile mornings and evenings and frankly nothing but rest and hot packs will even help a little.  I will not say this is severe and I am not able to be on my feet or at my desk all day.  

I've gone through the proper medical protocol of facet injections, medial branch blocks etc. in order to reach the point of discussing this procedure.  Radio Frequency Rhizotomy or a better term is "burning of the nerve" that transmits this particular pain.  (Thank God there is one, and we can get to it!!)  Pretty simple really, they go in just like an injection, ID the nerve and then burn the hooey out of it using radio frequency heat!  That little persistent nerve has a tendency to grow back within 6 months to a year and it typically has to be done again.  

Hey, at this point I would let them dive in there and do anything to get me out of this pain.  I've heard it is not much fun as they cannot have you under sedation for the procedure, but I am okay with that.  Just stop this unrelenting pain!!  

Many people have this done.  I have mine schedule for the 24th of March.  

I'd like to hear from anyone who has had this procedure and what results you experienced for a few months or few years.  I am very hopeful this will let me get back to normal functioning (and attitude) and maybe even put a few miles on the motorcycle this summer.  

I appreciate anyone's experience and or advice for heading in to have this done.  
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Member Comments (39)
Avatar_f_tn
by justmejen, Mar 17, 2010
Hi Jim, I'm sorry I can't give you any answers but I wanted to wish you luck with the procedure. My hubby suffers from lower back pain & has for years. When he was a kid he accidently stabbed himself with a pick ax while digging for fishing worms....dr gives him T3 & has never even ordered so much as an x-ray....I finally spoke to dr about it & he is going to schedule a CT scan....anyway,good luck & I hope someone can answer your questions & give you some peace of mind.

Jen
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by Mollyrae, Mar 17, 2010
Hello:

You might want to send a PM to a member by the name of SHELLBELL79. She has had this proceedure done a few times. She has stated that it's a very painful proceedure and they can give you medications to semi-sedate you.

Please contact her....she may be able to help you.

My best,
Mollyrae
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by Tuckamore, Mar 18, 2010
Welcome Back Dr. Humphries,

I am so sorry to hear about your continued pain. I too have problems with several facet joints.

I have facet joint disease. I have had nothing done for this because my SIJ Dysfunction is so severe. The spasms are horrid. I do know what you are talking about. Diazapam is the only medication that helps relieve those spasms and not give me a hang over effect.

I know we have had many ppl ask the same questions you are asking. Some have claimed relief while others have not. I think that's about the way it goes for most procedures.

Please let us know how effective the RFA is for you. I hope it will bring you significant releif. Some articles I have read state that as the new nerves regenerate they may not be so painful and the pain synapse does not occur as severely or as often in them. I hope that will be true for you.

Best of luck and take care. Chronic Pain is a horrid condition to live with....it ended two wonderful careers for me....you have my empathy.

Take Care,
Tuck

Avatar_dr_m_tn
Thanks you all, yes I understand that while the thermal destruction of this tiny branch leading from the facet joint can be effective, it does grow back in time.  However, it is a damaged nerve and that often a second (or third?) ablation will damage the tissue enough it will not grow back.  

At this point I'll try anything.  

I would love to hear from someone who has had this AND had good to excellent outcome.  I know PeekAwho had this not long ago, but she is having additional back issues so it is hard for her to say the RF was a good solution.  

It is an interesting procedure.  We use a similar procedure in horses with a certain type of lameness.  However it is an actual "neurectomy" where we physically remove a segment of the nerve.  But it is also more easily accessible than this Medial Branch from the facet in the human spine.  

I'll report here my experience.  

I need THREE levels done (both sides) BUT of course the idiot 'suits" at the insurance company will only allow TWO.  SO I have to go back 10 days later to have the other level done.  Could easily all be done at one time, but the brilliant insurance folks will end up paying DOUBLE for the process because of a "rule".  Just one tiny example of why costs are out of control and how there is no such thing as common sense in medical insurance - makes me very happy I'm a veterinarian.

BTW: MANY of my physician friends say they are already looking for other work because of the coming destruction to the way medicine is practiced in this country.  Heck its pretty bad now, I can't imagine what this would look like under 'government run' insurance.  God Help Us!  
Avatar_dr_m_tn
Thanks Shellbell79 for all your advice.  Sorry you are having such bad problems with pain.  We are all pulling for you.
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by Tuckamore, Mar 19, 2010
Oh don't get me started on the "government run" insurance proposals. It is at the very least, terrifying!

There are many areas of our medical delivery system that in my opinion require clean up and re-vamping. Certainly the insurance companies practices need to closely investigated. In my opinion that's what need to be done instead of the current destructive proposals. I'll get off my soap box now and keep the remainder of my opinions to myself.

I do know another memeber that has had this procedure done. I will give her a shout and see if she will share her experience also.

Wishing You the Best,
~Tuck
Avatar_dr_m_tn
Just FYI:  I am having my RFA tomorrow morning up in Denver.  I'll report back how the procedure went as well as results after the initial inflammation.  This is a common procedure and it should be described and reported here, but very little info here.  I'll let you know best I can on how it goes, and the effectiveness.  I need 3 levels done (6 spots) but insurance will only pay for 2, so I have to go back yet again for the third level.  Double the cost for a procedure that could easily be done in one step.  Not only is the insurance industry out of touch, but this bama-nightmare will only make things worse.  Oh, you are right... don't get me started.  
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by Tuckamore, Apr 06, 2010
Thanks Dr Humphries for your update. I wish you the very best tomorrow.

You are correct that this is a common procedure. Our information on the treatment varies by the members that are currently active. Sometimes we have great information as we'll have a few members that have had the procedure done several times. They leave and with it their departure so goes the personal information.

I have never had the procedure done so my information only comes from text books and the internet. Your right there should be more information here. I am currently working on a general information page that will contain information regarding common procedure such as the RFA among other things. But due to my time restraints and multiple obligations and chronic pain it is taking me longer than I had hoped.

It's a shame that the insurance would not cover it as a one time treatment procedure. And they complain about costs!!  My best friend, an RN that approves or disapproves insurance payments could write a book about the ineptness of the medical insurance industry. They don't listen to the ppl that know. In part it's about their initial outlay costs today and not tomorrow. They seem to have no forward thinking...they don't look at the big picture. But again I must get off this subject!!  

We'll look forward to hearing from you after your procedure in Denver. Best of luck to you!

~Tuck
Avatar_f_tn
by nurseaudrea, Apr 07, 2010
This is probably too late to let you know, but I also suffer from congenital Spondylolisthesis and had fusions done from L4-L5-S1, first anteriorly and then two years later posteriorly. I also suffer from facet arthropathy. It can be very painful. I had the RFA done about 5-6 weeks ago. It was wonderful. I do not remember the procedure at all. They sedated me first and then I suppose I woke up while finding the right nerve to let them know they were in the right spot. I do not remember anything of the procedure. The only thing I remember is going in and watching them give me something in the IV and the next thing I was waking up in the recovery room. It could not have gone any better. I do know the meds they gave me cause amnesia and they say I was awake and talking so I guess I have to go by what they say. That area feels so much better and now I am awaiting to have the same procedure done to my SI joints. Hope your procedure goes well.