RF facet denervation

The small joints in the posterior part of the spinal column are often a source of debilitating and constant pain particularly when they become worn and inflamed. If medial branch blocks with local anaesthetic has provided good but temporary relief on at least two separate occasions then these joints can be de-sensitised on a semi-permanent basis.

This procedure is performed as a day case under X-ray control.

Fine cannulae are guided onto the small branch of the main spinal nerve which supplies the pain sensation to the joint. For each joint at least two branches need to be located. For safety a small electrical signal test show close the needle tip is to the relevant nerve and ensures that there is no risk of the needle tip being too close to the main nerve which governs motor control. Once these conditions have been satisfied athermo couple electrode is placed through the cannula and a radio frequency current is then produced via the lesion generator to heat the nerve to a temperature of 80-85 degrees for a period of 90 seconds.

To reduce post-procedure soreness a small dose of local anaesthetic and corticosteroid is then depositedat the site and the cannula is withdrawn. Since several small nerves have to be treated this way the procedure may take an hour or so but it does not require anything more than local anaesthesia and is not a painful experience to the patient.

It may take up to a month following this before full relief is obtained.