RADIOFREQUENCY ABLATION

Radiofrequency Ablation

What is Radiofrequency Ablation?

Radiofrequency (RF) Ablation, (Denervation or Lesioning) is considered to be a safe, proven way of treating chronic Facet Joint Pain.

Who is a candidate for this procedure?

Individuals who have had spinal pain for at least 3 months and have tried more conservative treatment and the source of the pain has been determined to be the Facet joint.

How is the procedure performed?

With the patient lying on his or her stomach, the physician numbs the area with a local anesthetic. Under Fluoroscopic-Guidance, your physician will then place a small needle near the tiny nerves which innervate the Facet Joints causing the pain. A small electrode is inserted through the needle to lesion the specific nerve. Very light electrical stimulation will be performed to confirm the exact location.

How long is the procedure?

Approximately 30 minutes to one hour.

Will I be sore after the procedure?

Most people do experience some discomfort for 1 day to 2 weeks after the procedure. Medication may be needed for 1-2 days after the procedure to help with the discomfort. Ice may also be applied to the region.

How long does the effect last?

Usually from one to several years. The lesioned nerves do regenerate over time. If the procedure is successful for a long period of time and the pain returns, then the RF lesioning can be repeated.

Facet Joint

What is a Facet Joint?

They are located on the back of the spine on each side of the vertebra, and they overlap the vertebra under them.  The real name is the Zygapophysial Joint, which is also called the “Z” joint. These joints provide stability to the spine, and also allow the spine to bend and rotate as well as keep the back from slipping forward. There is a thin layer of cartilage between the two joint surfaces to provide smooth and efficient movements.

There are two Facet Joints at each spinal level. The joint itself is made up of two flat surfaces, which are lined with articular cartilage. The whole area is also supported by a fibrous capsule.

The integrity of the joint is closely related to the condition of the intervertebral disc. When the disc starts to deteriorate, the spinal load will increase on the joints, and they may become arthritic, enlarged, and painful.

Facet Joint Injection/Facet Joint Mediated Pain

What is Facet Joint Mediated Pain?

Facet joints account for about 20% of chronic low back pain and up to 50% of neck pain. Although certain physical exam testing and historical information is helpful in making the diagnosis of facet joint mediated pain, only a series of spinal injections into the joint (Facet Joint Injection) or the nerves that supply it can confirm this.

How is facet joint pain treated?

We typically prescribe treatments such as modalities (e.g., heat, traction), physical therapy, anti-inflammatory medications, Trigger Point Injections, and spinal manipulation to help with pain management.

If these techniques do not bring about the desired pain relief, we may perform a Facet Joint Injection, which delivers a steroid or anesthetic to reduce inflammation and pain. It will also help to better diagnose the problem.

We may also recommend other types of procedures such as Medial Branch Blocks (diagnostic only) or Prolotherapy.