Percutaneous Intradiscal Radiofrequency Thermocoagulation

Introduction

Percutaneous Intradiscal Radiofrequency Thermocoagulation (PIRFT) involves using radiofrequency energy to generate controlled heat within the targeted intervertebral disc. This heat is applied to coagulate pain-conducting nerve fibers within the disc, reducing pain transmission.

Clinical Indications

The clinical indications for Percutaneous Intradiscal Radiofrequency Thermocoagulation (PIRFT) include:

Chronic Low Back Pain: Particularly when the pain is believed to originate from the intervertebral discs.
Discogenic Pain: Pain arising from degenerative disc disease, including disc herniation, annular tears, and discogenic low back pain without radicular symptoms.
Failed Conservative Treatments: Patients who have not responded to conservative treatments such as physical therapy, medications, and epidural steroid injections.
Localized Pain: Pain that is localized to a specific disc level, confirmed by imaging studies such as MRI.

PIRFT is designed to target and coagulate the pain-conducting nerve fibers within the affected disc, providing relief from chronic back pain

Technique and Goals

Steps of the Procedure

Preparation: The patient is positioned on the procedure table, usually lying on their stomach or back, depending on the target disc. The area is cleaned and sterilized.
Anesthesia: Local anesthesia is administered to numb the skin and tissues at the insertion site.
Fluoroscopic Guidance: Fluoroscopy, a real-time X-ray imaging technique, is used to guide the procedure. This allows the medical team to visualize the spine's structures and accurately guide the needle and electrode.
Electrode Insertion: A specialized electrode is inserted into the intervertebral disc under fluoroscopic guidance. The electrode is positioned at the center of the disc.
Radiofrequency Energy Application: The electrode is activated to generate radiofrequency energy, which heats the disc to a temperature of around 70°C for about 90 seconds. This controlled heat coagulates the nerve fibers within the disc, disrupting pain signals.
Completion: Once the procedure is complete, the electrode is removed, and the patient is monitored for a short period before being discharged.

Procedure Goals

PIRFT is a minimally invasive procedure designed to treat chronic back pain originating from intervertebral discs. The procedure involves the use of radiofrequency energy to generate controlled heat within the disc, targeting pain-conducting nerve fibers.

Therapeutic Value & Duration

Therapeutic Value

PIRFT provides significant therapeutic value by offering immediate pain relief and restoring function. The procedure is minimally invasive, with a quick recovery time and minimal tissue trauma2. It is particularly beneficial for patients who have not responded to conservative treatments.

Duration of Effects

The effects of PIRFT can last for several months to years, depending on the individual patient's condition and response to the treatment. Many patients experience long-term relief from chronic back pain.

What to Expect

When a patient comes to the clinic for the PIRFT procedure, they can expect:

Preoperative Evaluation: Detailed assessment of the patient's medical history and imaging studies.
Surgical Procedure: The procedure is performed under local anesthesia with sedation, and live X-ray guidance is used to ensure accurate placement of the implants.
Postoperative Care: Patients are monitored for a short period before being discharged on the same day. Postoperative instructions include rest, limited activity, and follow-up visits to monitor healing.

Possible Side Effects or Complications

As with any surgical procedure, there are potential side effects and complications, including:

Infection: Risk of infection at the surgical site.
Nerve Damage: Potential for nerve damage during implant placement.
Blood Clots: Risk of blood clots forming in the legs (deep vein thrombosis).
Adverse Reactions to Anesthesia: Possible reactions to anesthesia used during the procedure.
Need for Further Surgery: In some cases, additional surgery may be required if the desired outcome is not achieved

We are here to help you

At the Institute of Interventional Pain Management, we are dedicated to helping patients with chronic pain by offering the Percutaneous Discectomy procedure, including advanced radiofrequency technology like PIRFT. Our goal is to provide effective pain relief and improve the quality of life for our patients. If you are suffering from chronic back pain, we are here to help you.