Abstract：
Radiofrequency ablation (RFA), a minimally invasive procedure for pain reduction, is increasingly used for managing chronic neck pain and headaches. This article offers a concise overview of cervical spine RFA. In the context of RFA, heat is applied to specific nerve tissues to interrupt pain signals. Wallarian degeneration occurs as a result of the thermal injury to the nerve. The heat generated by the RFA procedure can damage the nerve fibers, initiating the degenerative process. Wallarian degeneration is a process that occurs in a nerve axon due to the thermal injury, leading to the breakdown and eventual degradation of the axon and its myelin sheath. However, nerves have regeneration capacity, especially the peripheral nerves, which are often the target of RFA for pain management. After Wallarian degeneration takes place, the nerve sheath, or the connective tissue surrounding the nerve, can serve as a scaffold for the growth of new nerve fibers. Over time, these new fibers can regenerate and re-establish connections, potentially restoring nerve function. Three common types are traditional thermal, water-cooled, and pulsed radio frequency ablation. Given the regenerative potential of nerves, these procedures are typically effective for 1 to 2 years, with some variability. Despite a 112% increase in Medicare claims for RFA from 2009 to 2018, it\'s recommended for patients who respond positively to diagnostic medial branch blocks, with recent guidelines suggesting a single block may be sufficient. Although generally effective, the procedure carries risks, including nerve and tissue injury. Notably, the procedure\'s increased utilization notably surpasses the most commonly reported prevalence rates of conditions it aims to treat. Moreover, diagnostic blocks performed before cervical RFA also have their risks, such as inadvertent vascular injections leading to seizures or paralysis. In summary, the risks and benefits of cervical RFA must be considered with regards to the patient\'s comorbidities and specific pain issues. The skill and experience of the practitioner plays a significant role in minimizing these risks. Detailed discussions with healthcare providers about the risks, benefits, and alternatives can help in making an informed decision about the procedure.
摘要：
射频消融(RFA),减轻疼痛的微创手术，越来越多地用于治疗慢性颈部疼痛和头痛。本文提供了颈椎RFA的简要概述。在RFA的背景下，热量施加到特定的神经组织以中断疼痛信号。Wallarian变性是由于神经的热损伤而发生的。RFA程序产生的热量会损伤神经纤维，开始退化过程。Wallarian变性是由于热损伤而在神经轴突中发生的过程，导致轴突及其髓鞘的分解和最终降解。然而,神经有再生能力，尤其是周围神经，这通常是RFA用于疼痛管理的目标。在Wallarian变性发生后,神经鞘，或者神经周围的结缔组织，可以作为新神经纤维生长的支架。随着时间的推移,这些新的纤维可以再生和重新建立连接，有可能恢复神经功能.三种常见的类型是传统的热，水冷,和脉冲射频消融。鉴于神经的再生潜力，这些程序通常有效1到2年，有一些可变性。尽管从2009年到2018年，RFA的医疗保险索赔增加了112%，但建议对诊断性内侧支传导阻滞反应积极的患者使用，最近的指导方针表明，一个街区可能就足够了。虽然总体上有效，该程序存在风险，包括神经和组织损伤。值得注意的是,该程序增加的利用率明显超过了其旨在治疗的最常见报告的患病率。此外，在宫颈RFA之前进行的诊断块也有其风险，如无意的血管注射导致癫痫发作或瘫痪。总之,对于患者的合并症和特定疼痛问题,必须考虑宫颈RFA的风险和益处.从业者的技能和经验在最小化这些风险方面起着重要作用。与医疗保健提供者详细讨论风险，好处,和替代方案可以帮助对程序做出明智的决定。
