Radiofrequency facet joint denervation
Introduction
Radiofrequency facet joint nerve denervation is a minimally invasive pain management technique which coagulates and inactivates the nerves to the joints. This technique primarily involves coagulating the nerves that transmit pain signals from the joints, using highly localized radiofrequency energy at the tip of the needle.
Research reports
Recent research has indicated that the radiofrequency facet joint nerve denervation is an extremely effective procedure in treating conditions which have failed to respond to other therapies, especially the likes of chronic low back pain.
Studies at workplaces have also demonstrated that patients with chronic pain have largely benefited from this procedure. A recent study revealed that almost 92% of patients who have undergone this procedure, have returned to work just in two weeks.
Application and Uses
The procedure of radiofrequency facet joint nerve denervation is usually done in cases where the small joints in the posterior part of the spinal column become a source of debilitating and constant pain. This commonly happens when these joints become worn and inflamed.
Such joints can be de-sensitized on a semi-permanent basis for the purpose of pain-relief in patients where the spinal facet joint injections with a local anaesthetic and steroid have provided good but a short-term pain relief, at least on two separate occasions.
The Procedure
In this procedure, fine cannulae are guided onto the small branch of the main spinal nerve which supplies the pain sensation to the joint. For each of the joints, at least two branches are located for the procedure. For safety purposes, a small electrical signal is used to test how close the needle tip is to the relevant nerve. This is also done to ensure that there is no risk of the needle tip being to close to the main nerve which governs motor control.
Once these conditions have been met, a thermocouple electrode is then placed through the cannula. Now, a radiofrequency current is produced via the lesion generator to heat the nerve to a temperature of 80-85 degrees for a period of 90 seconds.
In order to reduce the post-process soreness, a small dose of local anaesthetic and corticosteroid is deposited at the site and the cannula is then withdrawn. Several small nerves have to be treated in this manner. Hence, this procedure might take an hour or even more for the entire process to get over.
The entire procedure is undertaken on an outpatient basis with minimal or even no sedation and the patient is generally allowed to return to normal activity, depending on the individual situation.
Complications and Side Effects
The radiofrequency facet joint nerve denervation is an extremely safe procedure and carries a minimal risk of side effects or complications. Such interventional procedures are generally carried out under constant x-ray screening, which enables the specialist to monitor the position of needles or instruments, considerably minimizing the risk of any complications.
A recent survey report stated that the procedure of radiofrequency facet joint nerve denervation reported a minor complication rate of 6.5%, when performed using appropriative techniques and equipment. In some cases, minor side effects like soreness or pain in the affected area might be experienced.
