Thermocoagulation or electrocoagulation is a technique that consists of destroying the nerve endings of the posterior joints in order to reduce pain. How is the intervention carried out? What are its indications? What risks? What recovery?
As its name suggests, thermocoagulation (or electrocoagulation, or rhizolysis) designates the phenomenon of coagulation under the effect of heat. Thermocoagulation is used in surgery to relieve chronic low back pain. For this, we use a needle through which a powerful electric current is passed. This current releases heat that burns the tissues with which it comes into contact. This destroys the nerve responsible for the pain.. However, thermocoagulation is likely to lead to muscle weakness.
Thermocoagulation is essentially indicated in patients suffering from low back pain and/or chronic neck pain. This technique is particularly effective in the case of lumbar facet syndrome which results in irritation of the joints of the vertebrae called the posterior joints. “The pain is relieved when the posterior joints are unloaded, that is, in the fetal position or gun dog. Beforehand, it is possible toperform infiltrations with anesthetics or corticosteroidswhose relief will be sustained by thermocoagulation”says Dr. Marc Lévêque.
The procedure lasts approx. 30 minutes and unfolds on an outpatient basis, under local anesthesia. The subject is lying on his stomach, a needle is lowered to the painful joint under X-ray control. Then, an electrode is positioned through this needle in order to perform a thermolesion of the nerve ramifications, also called rhizolysis. “The nerve endings are heated to 80 degrees so as to neutralize them. In general, we perform two to three lesions per joint in order to increase the chances of success, details the neurosurgeon specializing in pain.
“The risks of thermocoagulation are minimal. If the needle is incorrectly positioned, hematoma can occur. Other side effects that may occur are: an allergic reaction to the anesthetic product and tingling in the legrelated to overheating of the nerves of the leg. The risk of infection is almost zero because heating the electrode to 80°-90° sterilizes the area”, inform the specialist.
At the end of the intervention, it is recommended to rest until the end of the day and observe a work stoppage d48 to 72h. Thereafter, you will have to remember to bend your knees and keep your back straight to bend down. The dressing can be removed 24 to 72 hours after thermocoagulation. The results of this technique are generally visible quickly but can sometimes occur later, afterabout two weeks.
Thanks to Dr. Marc Lévêque, neurosurgeon specializing in pain, author of the book let’s free ourselves from pain (Éd. Buchet Chastel)
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