Here at the Spine Institute Northwest we are always striving to find new and innovative ways to offer our patients back pain and sciatica relief. We have many great minimally invasive surgical procedures available and skilled surgeons with years of experience ready to bring you relief. In part one of this series we talked about endoscopic decompression, facet fixation and interbody fusion. In part two we’ll discuss a couple more procedures: radio frequency neurotomy and endoscopic nerve excision. Our goal is always to help you feel better. Contact us today and see what we can do for you.
Radio Frequency Neurotomy
Radio frequency neurotomy is a procedure that deadens a nerve that is causing pain. This can result in extended pain relief that can last for months and sometimes even years. The radio frequency treatment interrupts the nerves ability to transmit pain signals through the use of thermal heat.
This procedure is done using fluoroscopy, a special type of x-ray that shows live images. We make a small incision and then guide the special radio frequency needles to the affected area. Once the needles are in place we apply thermal energy.
This procedure is completed rather quickly. We do it in our outpatient surgical center and it generally takes less than an hour with a short period of observed recovery time. The results are not completely permanent, but they are long lasting. Depending on how your body responds we may need to complete the procedure again in 6 months to a year. Some patients have pain relief for even longer periods of time.
After the procedure you will be a bit sore, primarily at the area of needle insertion and heat treatment. We recommend taking it easy for a day or two before resuming your regular activities. We’ll discuss specific recovery instructions at the time of your procedure. Radio frequency neurotomy can be an effective procedure for reducing back and neck pain. It is minimally invasive and has an easy recovery process .
Endoscopic Nerve Excision
Endoscopic nerve excision is very similar to the procedure we just discussed. Excision is a medical word meaning removal. During this procedure we remove a nerve that is transmitting pain signals. Although the root cause your pain may still exist, the removal of the nerve causes you to no longer feel the pain.
The major difference between needle RF and this procedure is the use of endoscope. We make a relatively small incision and guide the procedure using an endoscope and fluoroscopy to improve targeting and to reduce the amount of tissue damage. This makes recovery easier, reduces scarring and makes the procedure less painful.
By removing the nerve rather than just deadening it, we can create long lasting results. However, this doesn’t mean that pain will not return. Since this procedure is very new, the current research has tracked outcomes only for the past couple years, yet with satisfactory and very promising long term pain relief results.
Recovering from a nerve excision will take only a bit more time compared to needle Radiofrequency neurotomy. We generally recommend that you take it easy for several days after your procedure. We will provide specific instructions about what you can and cannot do in our offices. You may feel pain and soreness at the surgery site for a few days after the procedure. We typically ask that you have someone else drive you home.
If your back pain is caused by a facet disease, we may able to relieve your pain through one of these two procedures. By removing or deadening the affected nerve we can lessen your pain and increase your comfort levels. Call our offices today and schedule an appointment so we can determine if this procedure is right for you. We bring quality minimally invasive spine surgery to the Seattle area. You don’t have to live with chronic pain; there are many options available.
Don’t forget to check back on our blog. Part three which covers the pain pump and spinal cord stimulators is coming soon.

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I have a pinched sciatic nerve at L4 and have severe pain in both hip areas and also in the right knee area. Would any of these procedures, RFN or ENE help with this?