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  • AvatarJohnHixon
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    Post count: 2

    My wife had a radiofrequency ablation 2 months ago, June 12. Left C2, C3, C4.
    Since then her pain has gotten worse. In addition to the original pain she now has constant burning, stinging, shooting pain at the ablation sites that shoots over her head and goes into headaches.
    A cervical spine MRI performed in May 2018 showed an impression of 1. no acute findings and 2. moderate left neural foraminal stenosis at C2-C3 and C3-C4 may compress the left C3 and left C4 nerve roots.
    She has had chronic pain for 45 years and three fusion surgeries with the last a solid bone fusion of C4 through C7. There is an anterior plate with vertebral body screws at C4 and C7. There are bilateral facet joint screws with dual posterior rods providing posterior fusion of C4 through C7.
    The surgeon that performed the ablation has told her there is nothing more he can do.
    Do you have any suggestions of what we can do next to get relief?

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7262

    Ablations can injure and not destroy (ablate) the nerve if the heat ablation zone is in the periphery of the nerve and not on the nerve. A repeat ablation by another individual may be necessary. If her pain is more left sided, this could be radiculopathy (nerve root) pain. This can be identified by a selective nerve root block with a pain diary. See https://neckandback.com/treatments/epidural-injections-and-selective-nerve-root-blocks-diagnostic-and-therapeutic-neck/ and https://neckandback.com/treatments/pain-diary-instructions-for-spinal-injections-neck/.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    AvatarJohnHixon
    Participant
    Post count: 2

    It is unlikely that she would agree to another ablation. Since the procedure two months plus ago her pain has only increased.
    One question I have is: does the pain go away after a botched ablation or is it only going to get worse? Is there anything to help relieve the pain other than another ablation?
    She took morphine and fentanyl from 2004 to 2010 and after going through detox is determined not to use opioids again.
    When we began this recent treatment the doctor gave her a 5 day course of prednisone. During that time the pain went away. Is there a way to get pain relief other than more procedures?

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7262

    I can’t answer if the injured nerve will repair itself. Most of the time, ablated nerves do grow back so I would assume that this repair would occur but I can’t confirm that. I’m happy to note she does not want to get back on the opioid band-wagon as narcotics over time can increase pain sensitization. If oral steroids gave her relief, the consideration of a steroid injection around the medial branches (nerves that supply the facets) could be quite helpful.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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