General Guideline Principles for Radiofrequency Ablation,
Neurotomy, Facet Rhizotomy for workers compensation patients

The New York State workers compensation board has developed these guidelines to help physicians, podiatrists, and other healthcare professionals provide appropriate treatment for Radiofrequency Ablation, Neurotomy, Facet Rhizotomy.

These Workers Compensation Board guidelines are intended to assist healthcare professionals in making decisions regarding the appropriate level of care for their patients with ankle and foot disorders.

The guidelines are not a substitute for clinical judgement or professional experience. The ultimate decision regarding care must be made by the patient in consultation with his or her healthcare provider.

Radiofrequency Ablation, Neurotomy, Facet Rhizotomy

A technique intended to ablate the relevant sensory medial branches to cut/remove the fac point. The technique most frequently employed is continuous percutaneous radiofrequency.

It is advised that radiofrequency medial branch neurotomy be used instead of alcohol, phenol, other injectable substances, or cryoablation.

For the probe to be positioned precisely, fluoroscopic guidance is necessary. To document proper device installation, permanent photos should be taken.

Radiofrequency Ablation, Neurotomy, Facet Rhizotomy

Radiofrequency Ablation, Neurotomy, Facet Rhizotomy are recommended The use of neurotomy/facet rhizotomy/ radiofrequency may be recommended for individuals with verified facet joint discomfort in whom two diagnostic medial nerve branch blocks have been therapeutically effective.

Note: If there are a maximum of 3 facet joints involved, this surgery is not advised (four medial branch nerves).

An effective response to a interpret medial nerve branch block and a distinct modified block should be seen in all patients.

A reduction in pain of at least 50% from baseline throughout the period necessary for the local anaesthetic to take effect, associated with functional improvement, is required for a diagnostic block to be considered positive.

The patient should also list the everyday tasks that their discomfort makes difficult (this might include a range of motion assessments). In the clinical environment, the provider should notice and record functional progress in the listed activities.

1. Post-Procedure Therapy

   Post-Procedure Therapy is recommended Barring difficulties, it is advised to begin a modest reconditioning regimen during the first postoperative week.
   Exercises for endurance, cervical and thoracic strengthening, range of motion, postural or neuromuscular re-education, and stability should be taught and practised as part of a long-term home-based program.

   Frequency: 4–10 visits after the operation.

2. Repeat radiofrequency neurotomy (or additional level radiofrequency neurotomies)

   Repeat radiofrequency neurotomy (or additional level radiofrequency neurotomies) is recommended in a few individuals who experience recurring pain six to nine months after receiving pain relief from previous surgery.

   Note – If the patient’s pain pattern manifests differently than it did during the original examination, confirmation of the injection of the medial or Ch may be carried out effloresce and radiofrequency neurotomy.

   Frequency – Whenever pain and function improve, which is around twice a year

What our office can do if you need Radiofrequency Ablation, Neurotomy, Facet Rhizotomy

We have the experience to help you with their workers compensation injuries. We understand what you are going through and will meet your medical needs and follow the guidelines set by the New York State Workers Compensation Board.

We understand the importance of your workers compensation cases. Let us help you navigate through the maze of dealing with the workers compensation insurance company and your employer.

We understand that this is a stressful time for you and your family. If you would like to schedule an appointment, please contact us so we will do everything we can to make it as easy on you as possible.