The nerve destruction, often known as nerve ablation, is a method used to reduce certain kind of chronic pain, one of which is also chronic knee pain. Nerve ablation relieves chronic pain by preventing the transmission of pain signals. In general, it is a safe procedure in which a small part of the nerve is destroyed or removed in order to interrupt the pain signal. Nerve ablation can be done in different ways, using cold, heat or even chemicals. Depending from how the procedure is done, it is known as cryoablation, radiofrequency ablation, rhizotomy, or neurotomy.
Cryoablation is a minimally invasive procedure
Cryoablation uses a super-cooled material to destroy the damaged tissue. The use of Cryoablation for the management of pain has been around for a long time, but it was mostly done externally to cool the surface of the skin. However, the same technology has been taken further to manage pain internally, such as with knee pain and also to destroy cancer cells. Regardless of its use, the technology remains essentially the same.
Cryoablation is a procedure that tends to numb the nerves which cause chronic knee pain, with the help of the needles. Dr. Leon Reyfman is the best pain management specialist in Brooklyn and is among the top pain doctors in the region.
How does this procedure work?
Skin tissue and cells need to maintain a temperature of 37oC to survive, but they can also withstand lower temperatures for some time. However, extremely low temperatures can kill these cells immediately, and that is what Cryoablation does. Substances such as liquid nitrogen or a mixture of argon and helium may be used to lower the temperatures.
Knee pain is often caused by nerve endings in the knee being compressed by bone spurs that grow due to injury or arthritis. To solve this problem, surgery is recommended to remove these bone spurs, but this is a major surgery. Cryoablation is a much less invasive procedure and damages the nerve endings which are sending pain signals to the brain. It does not solve the problem, but it enables the individual suffering from knee pain perform many daily activities as well as increase their knee range of motion with the help of physical therapy.
How is the procedure done?
The main instrument for the procedure is the cryoprobe, which delivers either liquid nitrogen or argon into the source of knee pain. The cryoprobe is a hollow needle through which the super-cooled nitrogen or argon is delivered directly to the part of the knee that causes pain.
In order to determine where the needle is going, imaging technologies like MRI (magnetic resonance imaging), CT (computed tomography) and ultrasound are used during the procedure. These help to guide the surgeon to the exact spot and to avoid any mishaps.
Before the actual procedure, the individual is given a local anesthetic to reduce the pain because they will still be awake throughout the procedure. The use of Cryoablation to treat knee pain is an outpatient procedure, but it still requires the hands of a trained radiologist.
First, a small incision is made on the most appropriate side of the knee. The cryoprobe is then inserted through this incision, and with the help of the imaging technology, it is directed to the site of pain. Once there, the cooling fluid is delivered to the site, and that freezes the nerves which deliver the pain signals. At the same time, it also destroys the tissue which is causing the pain.
Once the procedure is finished, the cryoprobe is removed and the incision covered with a bandage. You will be advised not to move for at least a few hours, but you won’t have to be admitted in hospital and can be discharged on the same day. The procedure will take about 1 to 3 hours from start to finish.
Preparing for the procedure
Being minimally invasive, there aren’t many conditions, but you are advised not to take blood thinners such as aspirin or alcohol. Instead, you can take ibuprofen a few hours before the procedure to keep the pain away while you wait. You won’t need any painkillers through the procedure, though, because the surgeon will use a local anesthetic. Prior to cryoablation, motor and sensory nerve testing is performed to identify the nerve. Once the nerve is identified with the help of a nerve stimulation test, the temperature around the nerve is decreased to – 70 C.
Remember that cryoablation is not effective for everyone.
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