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Medial Branch Block and Radiofrequency Ablation

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    #1

    Medial Branch Block and Radiofrequency Ablation

    That's a mouthful LOL! Well, it's a procedure I think I vaguely remembered reading about on the old forums, or maybe it's new. But from what little info I found, it seems promising for me. I saw my pain doc and asked her about it. She said that Medicare requires the first procedure before doing the second. It entails injecting medication in the joints of the spine, and if that helps the pain, the same area is treated to a burning of the nerves. Unfortunately, it isn't permanent. And, it doesn't help sciatica, just low back pain. But that's my worst and most constant pain. So I scheduled it for December 17, in time for this year's used up deductible. I found a few good websites with info.

    Has anyone had this done? Any comments or info? I have so few options left... I don't want the SCS... I don't want more pain meds... Could this be the answer? I'm praying it helps me. I didn't get the EMG yet, nor the results of my triple MRI. I see the neuro 12/12 for results...

    Thanks for reading, I appreciate any and all replies! MarMar
    Herniated L4/L5 1998, Lami 8/99, Fusion 10/99, Fusion with Hardware 11/00, 2/13/06 fusion on L3/L4, emerg surgery 2/26/06 to stop spinal fluid leak and MRSA,3/10/10 Herniated L2/L3, fusion, replace hardware L3/4
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    #2
    MarMar, I haven't had this done but have read about it here and the people here that went through the process. It seems most people got relief from this I just don't remember how long they had the relief last. I would expect that it last as long as it takes the nerves to regenerate. Good luck with the procedure as I hope you get relief for a year or more.
    1979 spinal issues, 1993 lumbar microdisectomy L3-4, 1996 360 3 level lumbar fusion L2-5, 1999 open thoractomy fusion T8-9,
    2002 C3-7 herniations and T4-7 herniations, 2004 total disability, a new limited life

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      #3
      Thanks or replying!

      Thanks, Mark! I'll post after its done. I believe I read the relief can range from 6 to 18 months or longer. I'll take anything I can get! The title s/b thanks FOR replying, LOL...
      Herniated L4/L5 1998, Lami 8/99, Fusion 10/99, Fusion with Hardware 11/00, 2/13/06 fusion on L3/L4, emerg surgery 2/26/06 to stop spinal fluid leak and MRSA,3/10/10 Herniated L2/L3, fusion, replace hardware L3/4

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        #4
        I had RF ablation done about 9 years ago for right side pain as a result of cancer surgery. The doctor blocked the nerves he thought needed to be ablated the day before to give me a "trial." The trial eliminated nearly all the pain, so the next day he numbed up the area, gave me a bunch of versed, and did the procedure. I sort of remember some pain when he burned the nerves, but it wasn't too bad. Although the nerves eventually grow back, it sometimes breaks the pain cycle enough that the relief is permanent. Some 9 years later, I have pain in that area now and then, and may have it done again at some point, but for the most part it worked better than I expected.
        Diagnosed with stomach/esophageal CA in 10/99. Surgery opening abdomen and chest to remove stomach, esophagus, and spleen. Surgery about 10 days later for with lung infection. Was given about a year to live. 5 more surgeries in as many years, for hernias and adhesions, including removing about half of the colon. Thoracic problems from radiation, upper left abdominal pain from adhesions. Pump implanted in 2000. Shiny new pump in 2011. Oldest son diagnosed with stomach CA in 9/2000. Died 9/22/2001

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          #5
          Thanks!

          Thanks for the positive feedback. I had the injections Monday. My doc did the right side of L5/S1 and L4/L5 and both sides of L3/L4, which is where we think the problem is. I felt IMMEDIATE relief that has lasted so far for almost a week. I am supposed to record pain levels for two weeks and report back. I believe based on these results, they will burn my nerves too. I really think this could be it! I just wish more people knew about this procedure. I didn't. I had heard about it in the old forum, but I never investigated it enough to know that it might help me. I asked my pain doc why she never recommended it, and he said because I had stenosis. But surely it's worth a shot, right? Pardon the pun... Thanks again, Brion, for your input!!!
          Herniated L4/L5 1998, Lami 8/99, Fusion 10/99, Fusion with Hardware 11/00, 2/13/06 fusion on L3/L4, emerg surgery 2/26/06 to stop spinal fluid leak and MRSA,3/10/10 Herniated L2/L3, fusion, replace hardware L3/4

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            #6
            Update

            The pain relief lasted for about 12 days. So I had another round of 3 injections on each side, on Thurs 1/10. So far, lower back is very minimal, but sciatica is raging. I also have thus strange pain in the upper left back, under the shoulder blade that is aggravated by activity. I think these pains hurt worse when the lower back pain subsides.

            I'm hoping the next set is the ablation process. I'll post more results later!
            Herniated L4/L5 1998, Lami 8/99, Fusion 10/99, Fusion with Hardware 11/00, 2/13/06 fusion on L3/L4, emerg surgery 2/26/06 to stop spinal fluid leak and MRSA,3/10/10 Herniated L2/L3, fusion, replace hardware L3/4

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              #7
              Had the Ablation... (Wish they had a Post Icon for pained face!)

              The Radiofrequency Ablation was on 2/28. I had 7 injection sites!!! 8, actually. All were painful, doc says OK, a small pinch, and then OWIE! I tried putting Lidoderm patches on my back, but I didn't put them in the right spots. Kinda hard, doing it by yourself. But that was supposed to ease the pain of the pinches. The doc kept asking me if I had any leg pain during the procedure, which would be bad.

              So first is the pinch, followed by wiggling the needle. Then the numbing med. Then the test to see if the needle is in the right spot. I may have the previous 2 steps reversed. When all is good, she does the burning of the nerve. While this is working, she starts the next site. It wasn't fun, and took a while, but here's why I had 7 instead of 8. When the doc attempted to insert the needle at L3/L4, it felt like a hot poker was shoved into my upper right butt. I mean "almost fly off the table" pain. She kept trying, and each time was the same. The fluoroscope showed she had the right spot, but it was wrong for me. Now I have a lot of hardware and scar tissue so it's not easy doing the injections on me, but I also had a botched surgery at that level where the dura was cut and the nerve exposed, in addition to MRSA infecting the surgical site, back in 2006. Coincidence? I don't think so. I'm just worried that my worst level missed out on the Ablation. I don't know what will happen. And, I'm told the total effects won't be known for up to 6 weeks. I did not know that... The medial branch blocks generated an immediate benefit!!!

              So now I wait. Right now, there isn't much improvement, so I'm keeping my fingers crossed. I was surprised at how bad it was... And laying on your stomach for an hour is no fun. I made a recommendation - I asked the doc to tell her supplier that the table with the hole for your face (like a massage table) is good, but there should also be indents for boobs. Man, that was uncomfortable. Remember at the beach, Ladies, when we tanned our back, we made holes in the sand for the girls? Same thing is needed here. Hey, maybe I just hit on an idea for an invention.... LOL! I'll keep this post updated as I progress, and thanks to all who pop in to read this! MarMar
              Herniated L4/L5 1998, Lami 8/99, Fusion 10/99, Fusion with Hardware 11/00, 2/13/06 fusion on L3/L4, emerg surgery 2/26/06 to stop spinal fluid leak and MRSA,3/10/10 Herniated L2/L3, fusion, replace hardware L3/4

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                #8
                Update as of May 1

                Met with my pain doctor to report no pain reduction from the ablation. With my history of 6 spine surgeries, scar tissue and hardware, while the branch blocks managed to get the medicine to the right areas, during the ablation, which is more specific, the doctor was unable to get at the problem nerves. I even had another new pain in the butt for a few days, which was scary. But now I'm back to square one.

                We agreed to wait another 4 weeks, to see if any improvement results. It is almost at that point, with no change. My doctor informed me that Medicare will pay for the branch blocks every other month. But since the relief they caused only lasted about two weeks, it is a little depressing I can't have them more often. But maybe over time, the cumulative effect will eventually make the reduction in pain last longer.

                That's my plan as of now. At least I found something that gave me some relief. I think my pain is somewhat unique, in that if I'm lounging or laying down, I have no pain, except the occasional sciatica (which is drastically reduced by taking the anti depression med Nortryptiline). The unfortunate part is that consciously and subconsciously, I tend to want to stay home, lounging. Might sound great, but it's very lonely...

                Well, onward and upward! Hugs! Maryanne
                Herniated L4/L5 1998, Lami 8/99, Fusion 10/99, Fusion with Hardware 11/00, 2/13/06 fusion on L3/L4, emerg surgery 2/26/06 to stop spinal fluid leak and MRSA,3/10/10 Herniated L2/L3, fusion, replace hardware L3/4

                Comment

                  #9
                  Marmar, I was ready your past post and I am sorry I missed seeing them when you put them up. It is a shame you haven't gotten the pain relief you were after with the ablation. You may just be in the same position I am in right now; use pain meds to control the pain but learn to live with a good deal of pain anyway because the meds can't take the pain away just knock the edge off most of the time. I know you were hopeful about this procedure and maybe the branch blocks can start to last longer and provide you with more relief. Good luck and I will try to look for your post so I can keep up better with how you are doing. I just find it a bigger struggle any more checking all the post as I usually feel just good enough to just make a short visit. I am really struggling this week with my thoracic spine but I am expecting it to calm down at some point like it usually does.
                  1979 spinal issues, 1993 lumbar microdisectomy L3-4, 1996 360 3 level lumbar fusion L2-5, 1999 open thoractomy fusion T8-9,
                  2002 C3-7 herniations and T4-7 herniations, 2004 total disability, a new limited life

                  Comment

                    #10
                    Thanks Mark!

                    I certainly didn't expect anyone to reply, I was hoping to maybe help people who never heard of these treatments, by telling my experience. You and I seem to be in the same boat. But I'm afraid mine has a leak and it is sinking fast. I'm so very tired of dealing with the day to day struggle. Will it be a good day? Will I have to cancel appointments? Will my apartment stay dirty another day? I can do less and less every year. My big decision is to move to a 55 and over community, start fresh, and maybe I can shake some good out if this, before I become completely sedantary.

                    Thanks so much for your kind reply! Nice to hear from the old guard! Marmar
                    Herniated L4/L5 1998, Lami 8/99, Fusion 10/99, Fusion with Hardware 11/00, 2/13/06 fusion on L3/L4, emerg surgery 2/26/06 to stop spinal fluid leak and MRSA,3/10/10 Herniated L2/L3, fusion, replace hardware L3/4

                    Comment

                      #11
                      Marmar, boy do I understand the sinking boat analogy. I have gotten to the point that I just accept each day as it comes. Some days I sleep the whole day away other days I can't sleep no matter how tired I am. It is the same thing with what I do each day. I have given up trying to stay on a schedule and just do what I can each day. Most days it isn't much but every now and then I get a good day that makes me feel almost human again. I can't make appointments because I don't know if I can keep the or not.

                      If moving into a 55 and older community would help you stay independent then I say make the move. It isn't easy being on your own and living in a community with some help really could lessen the load you feel. I am thankful my wife is accepting of my condition as she helps me on the days I can't do things on my own. I hope you come up with something that makes life easier for you.
                      1979 spinal issues, 1993 lumbar microdisectomy L3-4, 1996 360 3 level lumbar fusion L2-5, 1999 open thoractomy fusion T8-9,
                      2002 C3-7 herniations and T4-7 herniations, 2004 total disability, a new limited life

                      Comment

                        #12
                        I have had the MBB and the RFA done a few times by two different doctors. Neither of the doctors helped me. I don't know if my body didn't respond or the doctor didn't do it correctly. The current doctor does not do MBB or RFA and has placed me on Suboxone, but I'm still looking for a doctor who will try it again. Hopefully the neurologist at Univ. Calif. San Francisco will try it. So far I'm impressed with his thoroughness.

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