Radiofrequency Facet Joint Neurotomy

Cervical Facet Radiofrequency Neurotomy "Radiofrequency Ablation" (RFA)

If you have been diagnosed with cervical facet joint pain (zygapophysial joint arthropathy) you may be a candidate for a cervical radiofrequency neurotomy. Neurotomy is a procedure which results in interruption of the nerve supply to a facet joint. This interruption, known as denervation, is accomplished by a radio-frequency (RF) probe that heats the 2 small nerve branches to each facet joint. From the C3-4 through C7-T1 levels in the cervical spine (neck) these nerves are called the medial branches. At the C2-3 level, the nerve is called the third occipital nerve (TON).

Video: Cervical Facet Radiofrequency Neurotomy
Click below to view a video from our library about this procedure.

How is it Done?

The procedure is performed in an operating room or procedure suite. With the patient in a prone position (on your stomach) and under local anesthesia (skin is frozen with numbing medication) and fluoroscopic (live x-ray) guidance, a radio-frequency needle is advanced to the base of the spinal bone that the nerve runs along. The needle is placed along the course of the appropriate nerve (medial branch of the dorsal ramus). The needle is heated to 80 degrees C for 90 seconds. At least 2 branches for each joint are treated in this same manner. Each branch may be heated 2-4 times to achieve a full clinical effect.

How Long Does it Take?

The neurotomy takes between 45 minutes and an hour and a half, depending on the number of levels to be done. The patient is then brought to the recovery area for 30 minutes of observation.

Potential Risk

The risks of this procedure are minimal. Theoretically, there is a risk of nerve damage to the larger spinal nerve where medial branch of the dorsal ramus originates. However, 3-step safety precautions are taken to avoid this and true nerve damage is quite rare. At one particular level, the C2-3 level, you may experience a patch of numbness at the base of your skull after the procedure. This is expected after a neurotomy of the third occipital nerve (TON).

It is not uncommon to experience increased localized neck pain for 1-2 weeks from the time of the procedure.

As with any injection procedure, there is a remote risk of bleeding or infection.

Expected Outcome

Following the neurotomy, there is a 60 to 70% chance of complete or near complete pain relief. This typically lasts for 9 to 11 months. However, the duration of relief can range from 6 months to 3 years. The nerve eventually grows back and the procedure can be repeated.

Lumbar Facet Radiofrequency Neurotomy "Radiofrequency Ablation" (RFA)

If you have been diagnosed with lumbar facet joint pain (zygapophysial joint arthropathy) you may be a candidate for a lumbar radiofrequency neurotomy. Neurotomy is a procedure which results in interruption of the nerve supply to a facet joint. This interruption, known as denervation, is accomplished by a radio-frequency (RF) probe that heats the 2 small nerve branches to each facet joint. These nerves are called the medial branches.

Video: Lumbar Radiofrequency Neurotomy
Click below to view a video from our library about this procedure.

How is it Done?

The procedure is performed in an operating room or procedure suite. With the patient in a prone position (on your stomach) and under local anesthesia (skin is frozen with numbing medication) and fluoroscopic (live x-ray) guidance, a radio-frequency needle is advanced to the base of the spinal bone that the nerve runs along. The needle is placed along the course of the appropriate nerve (medial branch of the dorsal ramus). The needle is heated to 80 degrees C for 90 seconds. At least 2 branches for each joint are treated in this same manner.

How Long Does it Take?

The neurotomy takes between 45 minutes and an hour and a half, depending on the number of levels to be done. The patient is then brought to the recovery area for 30 minutes of observation.

Potential Risk

The risks of this procedure are minimal. Theoretically, there is a risk of nerve damage to the larger spinal nerve where medial branch originates. However, 3-step safety precautions are taken to avoid this and true nerve damage is almost unheard of.

It is not uncommon to experience increased localized neck pain for 1-2 weeks from the time of the procedure.

As with any injection procedure, there is a remote risk of bleeding or infection.

Expected Outcome

Following the neurotomy, there is a 70% chance of complete or near complete pain relief (depending on the degree of relief from your diagnostic medial branch blocks!) This typically lasts for 10 months to 12 months. However, the duration of relief can range from 6 months to 3 years. The nerve eventually grows back and the procedure can be repeated.



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