Radiofrequency Ablation (RFA)

Fluoroscopy-guided thermal denervation of medial branch nerves and facet joints for lasting relief of axial cervical, thoracic, and lumbar pain — performed by Tzvi Grossman, MD.

How Radiofrequency Ablation Works

Radiofrequency ablation uses precisely controlled thermal energy to interrupt pain signal transmission along the medial branch nerves — the small nerves that carry pain signals from the facet joints to the brain. By creating a targeted, heat-induced lesion at each nerve, RFA provides durable relief from axial back and neck pain that is facetogenic in origin.

At SSMC, Dr. Grossman performs RFA under real-time fluoroscopy, confirming cannula placement at the classic target positions (waist of the superior articular process for lumbar; centromedial to the articular pillar for cervical) before applying radiofrequency energy. Motor and sensory testing is performed prior to lesioning to confirm proper needle position and patient safety.

Prerequisite: Diagnostic Medial Branch Blocks

• Typically two confirmatory medial branch blocks required
• ≥50–80% pain relief on both blocks predicts RFA success
• Insurance generally requires documented positive MBBs
• Dr. Grossman performs diagnostic blocks at SSMC

Pain Patterns Addressed

• Cervical: neck pain, occipital referral, cervicogenic headache
• Thoracic: mid-back pain, paraspinal aching
• Lumbar: axial low back pain, buttock referral
• Sacroiliac joint-related pain (lateral branch RFA)