Purpose of Technology: Radiofrequency ablation (RFA) is a percutaneous treatment that uses radiowave-induced heat to create a lesion in a spinal sensory nerve. Following a prognostic blockade to target the affected nerve(s), radiofrequency (RF) current is applied in a pulsed or continuous manner for several minutes via a needle electrode to the targeted nerves under image guidance. The goal of RFA is to relieve pain and symptoms of cervical or thoracic spinal origin by interrupting pain signal transmission from the sensory nerve to the brain.
Rationale: Percutaneous RFA of branches of the medial sensory nerves innervating the cervical or thoracic spine is thought to prevent transmission of pain signals to the brain. The goal of treatment is to relieve pain and related symptoms in patients who are not responding adequately to conservative therapy.
Controversy: The effects of RF neurotomy are not permanent, lasting from approximately 6 months to 1 year. RFA is thought to temporarily relieve pain by causing degeneration of axons within a target nerve or nerves. If pain recurs upon axonal regeneration, additional pain interventions may be required.
Is percutaneous RFA of spinal nerves effective for alleviating pain and other symptoms in patients with cervical or thoracic spinal indications?
Is percutaneous RFA safe for patients with cervical or thoracic indications?
How does RFA compare with sham RFA, local injections, pharmacotherapy, and other alternatives for relief of pain and symptoms related to cervical and thoracic spinal indications?
Have definitive patient selection criteria been established for RFA of the spinal nerves for patients with cervical and thoracic spinal indications?
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