Radio Frequency Dolor Barcelona
RADIOFREQUENCY consists in the passage of a high frequency current through a cannula that is totally isolated except for the tip (2-4 mm) which is the active part and which will exert the therapeutic action. When the current passes through the cannula, the temperature in it increases at the tip and in the rest it is totally isolated. The degree of temperature reached is controlled voluntarily.
Mechanism of Action
The increase in temperature in a target, usually a sensitive nerve responsible for the pain picture, has as a consequence the interruption in the transmission of pain (in the case of thermal radiofrequency at 80º) or as a modification in the transmission (in the pulsed radiofrequency at 40º). The procedure is performed with local anesthesia and with sedation.
The technique in expert hands and following safety advice, has few side effects. The procedure must be performed in an operating room to maintain asepsis, and with the assurance of an accurate view of the area that the cannula is inserted (ie under radiological control). It is not a medication and as it is a physical technique, there are the effects derived from the inconvenience of infiltration that are minimal due to local anesthesia and sedation. Others, in the case of not controlling the insertion of the cannula, could lead to an unwanted puncture in another structure and / or between them a vessel and cause a bruise.
Other safety measures in regard to the technique would be the verification of sensory and motor stimulation once we have the cannula in the proper location and radiologically controlled. With appropriate questions to the patient prior to practicing the radiofrequency stimulation parameters in which the patient perceives a tingling sensation (paresthesia) in the region which has the pain is practiced. This represents that have the cannula in proper position. To corroborate that it is not a motor nerve, it is asked and visualized, by giving a more potent stimulation than any structure (arm, leg) to move when applying this discharge. If so should reposition the cannula.
Cervical radiofrequency can be performed on all facet joints as shown in the figure in C4C5C6C7 i T1
The objective is to apply it to the dorsal branch of the posterior spinal nerve that is responsible for the innervation of the facet joint. The image visualizes the distribution of lumbar nerves.
Radio Frequency Indications
- In the spine: cervical, dorsal, lumbar, arthritic pathology, vertebral lesions.
- Facet pain (vertebral joints)
- Pain from osteoarthritis of the hip, knee and shoulder.
- Dolor discogénico: hernias de disco, ciática.
- Discogenic pain: herniated disc, sciatica.
- Pain after spine surgery.
- Pain in the sacroiliac joint (between the sacrum, the ilium and the coccyx).
- Complex regional pain syndromes with pain maintained by the sympathetic nervous system.
- Trigeminal essential neuralgia
- Certain cases of migraine
- Pain in peripheral nerve territories: intercostal, suprascapular, pudendal nerve, abdominal pain, etc.
- Pain in certain painful points (trigger points)