Radio Frequency Facet Joint Rhizotomy

Facets are the surfaces of the joints in the spine. Back or neck pain may be caused by problems with these surfaces. A medial branch neurotomy (or facet joint rhizotomy) can help relieve pain by using heat to break down the small nerve branches (medial branches) located on the facets. If a facet injection has been successful in the past (provides 50% or better relief), then this procedure should be effective as well – possibly even providing pain relief for multiple years.

The procedure works by destroying the medial nerve branches of the facet joint, which stops the pain signals from reaching the brain. The treated nerves most often regrow within 6 months to a year, although pain relief should last up to 3-5 years. Depending on how long pain relief lasts, when it does return, the procedure may be repeated.

How to Prepare for the Procedure

Tell your doctor of any medication that you are currently taking, including aspirin. Ask if you should stop taking them before your treatment. Tell your doctor if you have any allergies, or might be pregnant. Do not eat or drink 8 hours before you check in for your treatment.

Procedure Overview

Before the procedure, you will be asked to fill out some forms, including a consent form. To help you relax and be comfortable, you may be given some light sedation and medication through an IV line (not general anesthetic). You will lie on an exam table on your stomach. The skin over the treatment site will be disinfected and numbed with local anesthetic. An X-Ray imaging machine will be used to help your doctor see the spine and guide the treatment.

After the Procedure

Most often, you can go home in about an hour. You are required to have someone (an adult friend or relative) drive you home. Relax at home for the rest of the day after your treatment, even if you feel good. The treated area may feel swollen and more sore than usual. This is normal, and can last from a few days to as long as 4 weeks. Because of this, the success or failure of the treatment is evaluated 1 month after the procedure is performed. The ability to return to work the next day will be evaluated on an individual basis.

If you have a fever over 100° F, chills, redness, or drainage at the treatment site, call your doctor.

Risks and Complications

Risks and complications are rare, but can include: Infection, increased pain, numbness, weakness, nerve damage, bleeding, or failure to relieve pain. Any post-procedure discomfort is usually easily controlled with standard medications.