HEALTH & MEDICINE :: FEBRUARY/MARCH 2007
Radiofrequency Neurotomy: An Alternative Treatment for Chronic Neck & Back Pain
As we all know, millions of Americans suffer relentlessly from chronic neck and back pain and neck generated headaches that are unresponsive to traditional means of care.
The Delaware Spine Institute provides an alternative treatment option for this. There are specific nerves that are responsible for transmitting painful signals to the brain from the joints of the spine. There are a lot of techniques we can use to block or “lesion” nerves in general. We can use local anesthetics, alcohols such as phenol, cryotherapy (i.e. cold) as well as heat in the form of radiofrequency. Radiofrequency has advantages to the others; the lesion size and temperature can be meticulously controlled, the nerve can be stimulated to help in identifying and facilitating accurate electrode placement, the recovery rate from these procedures is rapid and associated with low morbidity comparative to the use of local anesthetic, and finally, these lesions can be repeated if the pain returns. Significant relief can last from 3 months to 2 ½ years. If radiofrequency is repeated in the neck, there is an 82% chance of reinstating that relief, and in the back 85%.
After a spine joint is established as the patient’s structural pain source, the nerve is completely anesthetized, and a procedure, resulting in interruption of the pain generating nerve fibers to that joint, can be employed using radiofrequency energy. Most patients report the procedure to be relatively painless. Afterwards, they can expect stiffness and soreness at the location of the procedure, which is judiciously managed as typical post op pain. This lasts anywhere from 1-3 weeks. Patients usually return to work approximately 4 days after the procedure.
I have been teaching physicians nationally the appropriate implementation of this procedure and as with any therapeutic procedure, optimal results occur when very stringent selection criteria are utilized with precise radiofrequency lesion techniques. Having the opportunity to share my knowledge with other doctors has been an incredibly rewarding experience allowing more patients in more communities to reap the benefits of radiofrequency.
Appropriate radiofrequency probe placement for lumbar and cervical Neurotomy is demonstrated below respectively.
Radiofrequency lesioning has been used medically for almost 100 years. In the 1920s, it was found that radiofrequency in tissue caused rotational movement of ions inside the tissue cells, which in turn lead to the ions rubbing against each other inside these cells causing friction and then heat. The heating mechanism is analogous to the heat generated when one rubs their hands together. This technology was eventually employed to cauterize tissue by what is now called thermo coagulation.
In summary, as a Spine Interventionalist, I am able to provide a specific structural diagnosis for the pain causation and offer specific treatments based on those findings to improve patient outcomes. The only option for spine related pain used to be wide incisions or even sometimes lasers. Now we can offer diagnostic and therapeutic procedures through a skinny needle. Typically our referrals come from highly trained spine surgeons who are looking for a precise diagnosis so that they can make the smallest incision with the lowest associated cost and best outcome for the patient.
Dr. Lieberman is a Physiatrist who received his B.A. in Biology, magna cum laude from Temple University in Philadelphia. After graduating from The Philadelphia College of Osteopathic Medicine, he began working in primary care/internal medicine; he completed his Physical Medicine and rehabilitation residency at Temple University Hospital. He subsequently received post-graduate training in spinal injection procedures at the East Texas Medical Center in Tyler, Texas and at Magnolia Diagnostics in New Orleans. Dr. Lieberman is certified in both Physiatry and Pain Management. Dr. Lieberman is an attending Physician at Kent General Hospital, and serves on the hospital’s Trauma Committee.
Please call the office at 302.674.8444 for more information and to make an appointment. Delaware Spine institute is located at 1673 South State Street, Suite B, Dover, DE 19901.
Testimonial:
“When I came to Dr Ron Lieberman, I was in radical pain. I could not stand, sit, walk or rest without pain. My wife had to help me with my socks and shoes in the morning. I could not lift or play with my children without pain. I was grouchy, irritable and hurting all of the time. My life has improved drastically since my treatment began. I am pain free 90% of the time. I am happy, active and love living again. My situation is no longer hopeless but is now treatable and full of hope. My family and I are happy and active together!” ~Greg Akers ....patient
