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Overview

This minimally-invasive pain management procedure, also called radiofrequency (RF) rhizotomy, reduces or eliminates the pain of damaged facet joints by disrupting the medial branch nerves that carry the pain signals to the brain. It is performed using local anesthetic to reduce pain

Indications

Conditions that are well suited for this treatment are the same ones that can be treated by cervical medial branch nerve blocks. These include neck pain that is non radicular, motion sensitive, or associative with facet joint types of pain sources. Cervicalgia, degenerative joint pain, spondylosis, neck injury and some whiplash injuries are all treated with medial branch blocks and facet radiofrequency rhyzitomy if indicated.

This procedure is usually indicated for a more long lasting effect of pain relief after a prior medial branch block has shown effective relief. The same nerves are then indicated for the rhyziotomy procedure in order to prolong the pain relief. The area ‘burned’ is usually around 10 mm and the nerve can grow back with pain recurring after a prolonged period of pain relief.

What to Expect

1. Cannula Inserted – A needle like tube called a cannula is inserted and positioned near the irritated medial branch nerves. Fluoroscopic x-ray is used to help position the cannula properly.
2. Electrode Inserted – A radiofrequency electrode is inserted through the cannula. The physician tests the electrode’s position by administering a weak electric jolt. If the stimulation recreates the pain without any other muscular effects, the electrode is positioned correctly.
3. Nerve Treated – The physician uses the electrode to heat and cauterize the nerve. This disrupts its ability to communicate with the brain, blocking the pain signals. The physician may treat multiple nerves if needed.

Outcomes

Although pain may increase for the first week after the procedure, the patient usually has full relief from pain within a month. Successful radiofrequency neurotomies can last longer than steroid block injections. The nerve may grow back and pain may recur with good pain relief for up to several months or years.