Occipital Radiofrequency ablation is used to treat occipital neuralgia, which is a condition in which the nerves that run from the top of the spinal cord up through the scalp, called the occipital nerves, are inflamed or injured. The condition takes the form of very extreme headaches, which are often accompanied by other symptoms, including pain at the back of the eyes, light sensitivity and the scalp being ultra-sensitive. Radiofrequency ablation (RFA) is performed under local anesthetic with fluoroscopic guidance. A needle electrode is inserted through the skin and then into the tissue to be ablated. Patients who get temporary pain relief from occipital nerve blocks may be suitable for occipital nerve radiofrequency ablation. This is likely to provide longer-term pain relief.
Prior to the procedure:
- Once your admission has been arranged you will be notified of the details in writing. Prior to your admission to hospital we will contact you by phone to confirm all of your admission details.
- You will be required to fast (NIL BY MOUTH – including water) for 6 hours prior to surgery.
- If you are on aspirin or blood thinning medication such as Disprin, Plavix and Asasantin; or fish oil or krill oil you need to cease this medication 7 days prior to your admission.
- You will need someone to drive you home after the procedure.
What will happen?
- You will be admitted to hospital and be seen by a neurosurgeon who specialises in these procedures.
- Local anaesthetic is usually injected under the skin before the needle is inserted.
- In the procedure room, you will be positioned onto the X-ray table – face down.
- The procedure will be performed under X-Ray Guidance (Image Intensifier) to ensure the accuracy of needle placement. It is a sterile procedure, which passes a needle through the skin along the bottom of the skull between the midline and the ear. Specialized equipment including radiofrequency machine, probe, and RF needle is utilized for the nerve ablation.
- Post operatively patients are monitored for several hours. If pain is well controlled and the patient is safe to do so they can usually return home the same day as the procedure takes place.
- Before you leave the hospital, your doctor will give you instructions on how to care for your incisions and what activities you should avoid during your recovery.
- The local anaesthetic is responsible for immediate pain relief, whereas pulsed radiofrequency takes 4 to 6 weeks to provide sustained pain relief. Pain relief from pulsed radiofrequency ablation of the occipital nerve can last between 6 months to 24 months.
- Your surgeon will see you for an outpatient follow-up in 4 -6 weeks
- If you have any issues, you should follow up with your usual treating neurosurgeon.