A radiofrequency neurotomy is a type of injection procedure used to treat facet joint pain.
Facet joints are pairs of small joints between the vertebrae in the back of the spine. The facet joints support the spine while also allowing motion in terms of bending, flexing and twisting. Each facet joint is connected to two small medial branch nerves that carry pain signals from the facet joints to the brain.
A number of spinal conditions can lead to facet joint pain, such as osteoarthritis and spinal stenosis, or from a trauma to the back, such as a car accident.
A radiofrequency neurotomy - also called radiofrequency ablation - begins with the patient laying face down on a table. The skin and tissue over the procedure site is numbed with an injection of local anesthetic.
Next, the physician uses x-ray guidance, called fluoroscopy, to direct a special radiofrequency needle alongside the medial nerves.
Often, a small amount of electrical current is carefully passed through the needle to assure it is next to the target nerve and a safe distance from other nerves. This current should briefly recreate the usual pain and cause a muscle twitch in the back.The targeted nerves will then be numbed with a local anesthetic to minimize pain.
The radiofrequency waves are introduced to heat the tip of the needle and a heat lesion is created on the nerve to disrupt the nerve's ability to send pain signals to the brain.
As with many spinal injection procedures, radiofrequency neurotomy works better for some patients than for others. It is often helpful in reducing a patient's pain enough to participate in a rehabilitation program.