[Robertden]

#35641

Hi again Dr.. A second surgeon looking at my MRI says there’s no loose screw and my 3 level ACDF has fused very well but as I said earlier my headache returned 3 months later especially after a lot of neck movement. Prior to neck surgery I had 6 neck steroid injections which unfortunately did nothing. Also prior to the ACDF I had 2 radio frequency ablations which also did nothing. Is the ablation neurotomy most likely not worth the attempt a 3rd time(after the ACDF) if two attempts before the ACDF were fruitless? Thanks for sharing your experience in advance.

[Robertden]

#35642

Just to provide more information the 3 levels were C4-C6 which I’m told is not usually a source are for headaches but stretching and stress above these levels may be the source. But focusing on what I wanted to know was, would a third radio ablation probably not work if the first two did nothing?

[Donald Corenman, MD, DC]

#35643

Radio frequency ablation (RFA) is used to “kill” the sensory nerve that supplies the facet that is causing pain. If the test of that pain generation, the “facet block” give you no temporary relief, then the ablation will not work. If the block did relieve your pain, then a 3rd RFA attempt will not be effective if it is the same level. Please see these pages.

https://neckandback.com/treatments/facet-blocks-and-rhizotomies-neck/
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.

[Robertden]

#35644

The key sentence to me was ” a 3rd RFA attempt will not be effective if it is the same level”. I will ask my pain management Dr. if a different location might be worth a try. He however is so reluctant to try diagnostic nerve blocks for some reason and talks me out of them although I believe they would really be illuminating. As you say repeating the RFA at the same spot wouldn’t make sense. Thanks Dr..

[Donald Corenman, MD, DC]

#35645

I believe they could not proceed with RFA unless they had at least one if not two blocks that gave you some relief (diagnostic blocks). Do you know what levels the initial blocks were performed at and do you remember any temporary relief?

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.

[Robertden]

#35646

Believe it or not they(Stamford Hospital Pain management in Ct.)and as good as they are, never did a diagnostic nerve block although I practically begged for it after reading how determinative it could be. To the best of my recollection they did the two RFA’s at C2-C3. The two surgeons’ best guess as to the source of my returning pain as well as yours in the forum entitled ‘Headache after ACDF’ was stress above the ACDF at C3-C4, which is probably where the RFA should be directed.

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