Radiofrequency Facet Ablation
A facet rhizotomy destroys facet nerve(s) either in the lower back (lumbar) or the neck (cervical) region, using radiofrequency (heat) waves. This procedure is done if you have pain due to disease in the facet joints of your spine, and you have had pain relief from your facet nerve blocks. You will be placed in the prone position. Your back or neck will be cleaned with an antiseptic solution and the skin area will be numbed with a local anesthetic. Fluoroscopy is used to guide the placement of the needle probe to the area of the facet nerve. Radiofrequency waves are transmitted to lesion (destroy with heat) the involved nerve(s). This temporarily stops sensation from that area, which may last for an average of 6 months or more.
During this minimally-invasive procedure, the physician uses heat from radio waves to treat painful facet joints in your neck. This procedure is also called Radiofrequency rhizotomy. It can treat pain that doesn’t respond to medications or to physical therapy.
In preparation for the procedure, you lie on your stomach. You are given medicine to make you feel relaxed. The skin and tissue of your neck is numbed.
Inserting the Cannula
The physician inserts a tube called a “cannula.” A video x-ray device called a “fluoroscope” helps guide the cannula to the medial branch nerves in your spine. These tiny nerves carry pain signals from your facet joints to your brain.
Treating the Nerves
The physician inserts an electrode through the cannula. A weak electric jolt is used to test its position. If the jolt recreates the pain but does not cause any other muscular effects, it is positioned correctly. Then the physician uses the electrode to heat the nerve. This disrupts its ability to transmit pain signals. Several nerves may be treated if necessary.
End of Procedure
When the procedure is complete, the electrode and cannula are removed. A small bandage is placed on your skin. You will be monitored for a brief time before you are allowed to go home. Your injection site may feel sore after the procedure, and you may still have neck pain. If the correct nerves were treated, you will gradually experience pain relief as you heal. This may take several weeks. Your relief may last for several months.