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Radiofrequency Lesioning

Radiofrequency lesioning is the procedure of choice in many painful conditions. In simpler language, lesioning basically pertains to making a structure non functional by means of destroying or burning it. In certain kinds of painful syndromes, the pain is limited to certain specified locations subsreved by some particular nerve or its branch. In many instances due to injury or post injury certain malfunctioning changes occur in the nerve or root causing it to start sending false signals to the brain. This implies that in many such cases, despite there being no damage or disease in the organ or part of the body, patients still perceive a signicant amount of pain. By doing lesioning, one particular nerve or root is destroyed by various means to break the conduction of signal from the periphery to the brain, whence that territory of the body becomes insensitive or numb. Previously this used to be done with the help of various chemical agents, like phenol, absolute alcohol and glycerol etc. With the advent of technology newer modes of lesioning have come up with many advantages over the previous ones and include cryo probes, laser and radiofrequency. Out of these, radiofrequency has become the technique of choice and is referred to be the gold standard in pain management.

 

Radiofrequency comes in two modes, namely, conventional and pulsed. Lesioning with radiofrequency has the advantage of selectively targetting only the pain carrying fibers. Certain neuralgias, like trigeminal and glossopharyngeal neuralgia, are treated with radiofrequency lesioning and are the techniques with the most promising results. With the advent of pulsed radiofrequency, motor and sensory functions are preserved and only the fibers carrying the pain fibres are targetted. Pulsed radiofrequency does not burn or destroy the nerve and is thought to alter the pain conduction only, or so called, neuromodulation. The advantages of this feature are that, there is no gross numb feeling in the spcified area. The sensaton of touch and temprature remains.