Radiofrequency Neurotomy of Facet Joints

What Is It?

A radiofrequency neurotomy or ablation is a procedure performed on the nerves that supply the painful joints. The ablation decreases pain signals being sent to your brain by interrupting the nerve supply to the joints. Radiofrequency Neurotomy decreases pain signals by placing a needle next to the nerve and heating the needle to approximately 85 degrees. Patients may be offered this procedure following a positive response to medial branch blocks or facet joint injections. A positive response to test injections may only be for hours.

How long does it last?

Pain relief varies between individual patients, but can last between 3 and 24 months. The average result is 9-12 months. It is necessary to note that this is not a permanent solution and is not always effective.

Will I Be Awake and Is It Painful?

Sedation is a popular option that is offered, it can reduce the stress and discomfort of the procedure. An alternative to sedation is receiving a local anaesthetic to numb the area during the procedure, it is imporant to note you may feel an amount of discomfort during the procedure, and after the numbing injection wears off.

Preparation

You should notify the specialists if you are: taking blood thinners; diabetic; pregnant; allergic; or unwell. Before the procedure, you should: avoid eating for 6 hours; continue to drink clear liquids until 3 hours prior; arrange for a family member or friend to accompany you.

What Happens After?

You will be placed in a recovery area for up to 90 minutes and are required to have someone with you overnight. For 24 hours you should refrain from driving, alcohol, machinery and important decisions. When you wash, you are required to take the dressing off.

What does the procedure involve?

The procedure involves: Changing into a hospital gown; Speaking to an anaesthetist if you are having sedation; You may have a small cannula inserted; Your heart rate, oxygen levels and blood pressure will be monitored throughout the procedure; The skin over the area to be injected will be cleaned.; Local anaesthetic will be injected into your skin.; Using an x-ray machine, a needle will be guided toward the target. If necessary, x-ray dye may be used to confirm the needle is in the correct position. Prior to the needle tip being heated, further local anaesthetic will be injected. The temperature of the tip of the needle is raised and if required, multiple injections will be used. A final injection of anaesthetic and steroid may be administered. Generally the procedure takes between 30-45 minutes.

Potential Complications

Pain or discomfort at the site of injection; A pain flare; Infection; Bruising; Muscle weakness; Bleeding; Allergic reactions; Failure of the procedure to reduce pain; Temporary nerve damage; Side effects caused by steroids can include transient flushing, mood swings, high blood sugar levels (especially in diabetic patients).

Consent

It is vital that you are fully informed of the procedure, what is involved, potential risks and side effects. You will be asked to sign a consent form. If you have any questions or concerns, please discuss these with your specialist. This form states you understand the potential benefits, risks, alternatives and what will occur if you do not go ahead with the procedure. You are free to withdraw consent at any stage up until the start of the procedure.