Pain Management: Selective Dorsal Rhizotomy (SDR) & Radiofrequency Ablation (RFA)

dallas medical hospital

Pain Management

SELECTIVE DORSAL RHIZOTOMY: A Surgery to Reduce Muscle Spasms

Selective dorsal rhizotomy, otherwise termed as SDR, is a surgical procedure performed on the spinal cord (lower back) to reduce spasticity. The goal of SDR is to relax the spastic muscles, therefore improving the quality of movement.

What is a muscle spasm?

Spasticity or muscle spasm is an increase in muscle tone that is described by some patients as tight or stiff muscles. It is caused by certain abnormal nerve fibers which results into a disruption of communication between the muscles and the brain. This results into a change in muscle tone.

Why SDR?

A thorough assessment is needed to determine if the SDR procedure is appropriate. Our medical staff and every patient’s family member collaborates to identify goals and care plan prior to the surgery.

SDR is recommended to reduce muscle spasm. The muscle tone will be more normal with less stiffness or tightness. This will allow movement to be easier.

What happens before an SDR?

As with any surgical procedures, assessments are done to create a baseline data. A series of clinical appointments as well as physical exam will be scheduled to gather detailed medical history. The purpose of these appointments is to make sure that you are healthy enough to receive anesthesia and proceed with the surgery.

What happens during an SDR?

SDR is performed under general anesthesia. You will be asleep during the procedure. While you are asleep, small electrodes are placed on the legs to check how the muscles responds. This is called neurostimulation. Neurostimulation helps the surgeons to determine which nerves are abnormal. The abnormal nerve fibers are then surgically cut, that is why the procedure is termed as selective dorsal ‘rhizotomy’.

What is expected after an SDR?

After surgery, some pain and discomfort may be felt at the back. There may also be some leg spasms which are expected to be gone after a couple of days. You may be asked to rest to let the affected area to heal and minimize leg spasms. The medical team will, however, help you manage any discomfort and pain. A therapy will also be scheduled to increase your strength and muscle control after few days.

RADIOFREQUENCY ABLATION: Heat generating ablation technique

Radiofrequency ablation or RFA is currently the most commonly used percutaneous ablation technique. It has become the procedure of choice among all of the image-guided ablation methods because of its efficacy, safety, and ease of use. It is performed by using a medium frequency alternating current which generates heat to ablate (cut or destroy) a tumor, an unwanted nerve or mass, and other dysfunctional tissue.

Uses of RFA

The following are different uses of radiofrequency ablation:

  • local treatment of solid malignancies
  • treatment for Barrett’s esophagus.
  • tumor destruction
  • removal of abnormal electrical pathways which are the cause cardiac arrhythmia
  • treatment of skin lesions and varicose veins
  • treatment lower back, joints, buttock, hip, and groin pain.

Why RFA?

Over the years, RFA has been used for treatment of selected tumors, such as those involving the liver, lungs, kidneys, and the musculoskeletal system. It is minimally invasive and are mostly used in inoperable patients with high-risk health conditions or other comorbidities. RFA doesn’t require prolonged hospitalization because it can be performed on an outpatient basis.

Also, among the numerous choices for local tissue ablation, RFA is currently the front-runner and may be better than other ablative methods because the procedure itself is fast, easy, safe, and affordable.