Ablative Procedures include radiofrequency ablation, cryoablation, and other forms of neurotomy. They are typically performed to deaden nerves- typically to the facet joints- theoretically abolishing the back pain from these joints. Medial branch blocks are performed and repeated before ablation to confirm the nerves in question as pain generators. It is expected that the medial branch nerves will eventually grow back three to nine months later, and, if the pain returns or comes back worse, the procedures can be theoretically be repeated again.
The reality is that they are often not 100% effective or effective at all. In addition, there is the potential that further rehabilitation will be compromised. The nerves in question, the medial branch nerves to the facets, are the sole innervation to the facet joints, and consequently, if they are ablated, they cannot provide feedback to the central nervous system when stabilizing core trunk muscles. Core stabilization, in turn, is one of the major foundations of modern spine rehabilitation. At Tristate Spine and Neuromuscular Associates we do not offer this intervention, except as a salvage procedure and last resort. It is also relatively expensive and in our clinic we believe that the risks do not outweigh the benefits in the majority of cases.