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Spinal nerve cauterization
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Spinal nerve cauterization

Hello,
I suffer from mild spinal stenosis and arthritis, coupled with severe degenerative disk disease, which has led to bulging and inflamed disks from T-7 through T-10. I've already had two cortisone injections into the facet joints, and neither gave me any pain relief for longer than a day.

My doctor now thinks cauterizing some of those spinal nerves might be beneficial, but I have several concerns. What are the success rates with this procedure? If my two prior injections failed, what's the chance this procedure will work? Are the any negative side effects to consider?

I appreciate your help!
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16 Comments Post a Comment
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Avatar_n_tn
Where is the answer to the spinal nerve cauterization question?
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648944_tn?1241473294
Hi, wordgirl/joan.

I'll try to help--I've had both procedures.

First, cortisone into the facet joints: like you, I experienced relief for only about 24 hours.  Not anywhere near enough to be worthwhile.

Second, cauterization:  I'm pretty sure that this is the same as radio frequency ablation ("RFA"), which I tried quite recently.  Again, what relief there was was very short term.  Others have told me that RFA is generally most effective when applied to patients whose pain condition started recently.  Mine goes back about a dozen years.

Having said that, you don't have a lot to lose by trying it, although I found the procedure itself to be rather uncomfortable.

Good luck!  Frank Paine
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547368_tn?1332173665
Hello Joan,

Welcome to the Pain Management Forum. The post that you asked your question on is a very old thread from 2007. I do not know where the responses are or if there were an. This forum is the Pain Management Forum for CP sufferers. We support one another and offer our opinions based on our experiences and for some our educations. There are no physicians here.

I can tell you that Spinal Nerve catheterization is a procedure where the physician uses a temperature controlled heat source inside a thin catheter to deliver high heat to the effected area. It is my understanding that there are several areas that this can be done. In the case of the spine the heat will cauterize the small nerve fibers and blood vessels, and shrink the material that makes up the annulus. The shrinkage improves disc function and the cauterization of the nerve fibers relieves pain. This procedure is performed only on patients who have failed conservative therapy such as epidural steroid injections, physical therapy, and medications.

You are wise to educate yourself to the procedure and ask many questions. There are success stories and there are others that have not had as much success. Much depends on the individual's disease anatomy as well as the experience and skill of the delivering practitioner.

If you have specific questions please feel free to post them and we members will do there best to respond.  Best of luck to you.

Tuck
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Avatar_f_tn
Understand how you feel I have had a hard time with builging disc in my neck I have had shots but they only help for a short time,maybe two weeks if I am lucky.they can only do a series of three shots after that IM not sure what is next.Heis taking about surgery,but if it helps im up for anything.Anyway good luck to everyone.   rily
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Avatar_n_tn
I tried the steroid injections with NO results. i have  a pretty significant case of scoliosis.. several pinched nerves, sciatica etc... I had the cauterization(4) and it DID help. I just had my second round and i am waiting. The pain can be worse for a week or so then gradually improves. I have been happy with my results. it's also pretty much a painless procedure. I hope that you have a reputable pain management doctor. They are usually anesthesiologists who also do PM. They also know more about the spine than any other MD...
I didnt have any anesthesia during childbirth but i assume that it's pretty similar to an epidural...I wish you pain relief!
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1199870_tn?1265298869
I go for this procedure today.  I am very encouraged by your results.  My Dr said, like you did, that it would possibly be worse, but then will improve.   He said it should last 8 to 12 months.   How long did it last for you the first time?
Thanks!
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Avatar_n_tn
is cauterization good indefinitely or only short term...
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Avatar_f_tn
Hi normorepain,

I would like to ask you to PLEASE go up to the top of the Pain Management Forum ans to REPOST you question as this is an OLD thread that you posted on.

I hope that you will repost this as it is a good question!

Thanks, ...Sherry
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Avatar_f_tn
I meant to tell you just go up to the "top of this post" and click on the green box that says "Post a Question".

Thanks...Sherry
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Avatar_f_tn
Hi, my docter was giving me injections into my neck. They do not last maybe less than two months. Next he wants to do burning the nerves in the neck. Is yhat what you have done. He gave me the same answer they told you.  Thank you in advance I await your answer
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Avatar_f_tn
How did you do with burning of the neck nerves,  i think i asked the wrong person my question. My dr. wants to the same to me as you did. my story is the same as yours.I thank you in advance for your answer.    I dont even know how you will answer
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Avatar_f_tn
Dear wordgirl,
I am giving you this info from an insurance stand point.  These are the requirements by ANY insurance company.  First you need to have a Facet injection or a Diagnostic Medial Branch block then follow up with your doctor "not less than 7 days" from the injection.  Your doc then needs to report a greater than 50% improvement in pain.  Then the injection needs to be repeated and follow up visit as well.  If facet inections do not work, it is likely to assume that the RFA will not either.  Your doctor should be discussing doing diagnostic injections prior to performing a RFA.  A diagnostic injection is usually in the Medial branch of the spine.  The medial branch is in the same location as the facet joint, however, two sets of nerves in the joint are hit. Example, L5-S1 makes one Medial branch.  The injection usually only consists of lidocaine and only lasts a few hours.  My docs give a "pain diary" to fill out for the following 6-8 hours after the injection as well as instructions to do the things that normally cause increased pain.  I'm sorry this is so long.
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Avatar_f_tn
Wordgirl,
PS, most insurance companies allow RFA's to be repeated every six months.  I have seen them last much longer.
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Avatar_f_tn
I have had both ... just having my cervical facet nerves cauterized two days ago. I would have to say that the procedure itself was less painful for me than when they numbed them to see if it would help. However, it is a longer procedure as the Dr. "must" ensure he/she is cauterizing the correct nerves. For me, the first two he got right away. However, the third one, they would send electrical impulses down in and I kept feeling it in my arm. I remember his tone in questions showed me he was a bit frustrated as he just could not find it. However, in the end he did. I thought I would rebound really fast (like the next day). However, that is not the case. I have had reccurring headaches and my neck is rather swollen and sore. I am told to give it 3-4 days and I will likely feel much better. I am praying this works. Best to you.
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Avatar_f_tn
Follow up to my comment ... My neck pain is now much much much better. I am left with a different type of discomfort, more of a burning feeling toward the bottom of where it used to constantly hurt in my neck. The doctor and nurse explained to me that my brain is searching and searching for that pain. This is because I had it for so long. However, my brain will stop searching likely within 4-8 weeks of the procedure. Now, yesterday I had my lower right nerves cauterized. Wow - I was in so much pain yesterday that I just had to sleep. My dear dear niece came every hour on the hour to apply a new icepack. That helped a lot. Now, it is Day 2 and I feel 50% better than yesterday. Yes, my back still hurts; however, I remember with my neck that it got worse before it got better. So, I will proceed with an optimistic view that my brain is going to stop looking for that neck pain "and" my back will follow the same path. I will really take it easy this week until my lower back pain either subsides or at least goes back to what it was. I will let you know how it all works out.
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Avatar_f_tn
I had a lumbar epidural 2 weeks ago that helped a lot  he is going 2 do more cortisone in facet lumbar joints and cauterize some nerve endings on Tueso relieve my sciatica on both sides.  Any advise?
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