Facet joint nerve radiofrequency treatment

What is a facet joint radiofrequency denervation?

The human spine is made up of a number of bones stacked up on top of each other, these bones are called vertebrae. The little joints that link the vertebrae together are known as facet joints. They help to stabilise your spine and allow movement. Facet joints occur in pairs along the length of the spine. The ones that cause the most problems are those in the neck (cervical facet joints) or those in the lower back (lumbar facet joints).

A denervation is a procedure that aims to modify the way in which pain is transmitted from the facet joints to the brain. The nerve is interrupted by heating it with an electrical current from a special device, called a radio-frequency machine. This procedure is usually done after other procedures, such as facet joint injections.

Benefits

If you experienced temporary pain relief following a facet joint injection, it is possible that the facet joint denervation procedure may enable you to experience longer-lasting pain relief.

Risks

Unfortunately no procedure is risk free. Short term side effects include pain and discomfort at the site of the injection, infection, bruising and bleeding. There is a possibility that you may have an allergic reaction to the drugs used. The procedure can cause some numbness in the buttocks and legs. This is temporary and will usually resolve. Long term effects are uncommon and include the possibility of an increase in pain as well as permanent neurological problems such as numbness and weakness.

Before the procedure

• You will receive treatment as a day case.

• You will be sent an appointment to attend the surgical day unit.

• You should arrange for someone to drive you home after your injection.

• Your stay may vary between two to four hours.

• Please bring a list of your current medications with you.

• You will be asked to undress and put on a theatre gown (you can keep your underwear on).

• Your doctor will discuss the procedure with you and ask you to sign a consent form. As the procedure involves the use of x-rays please inform the doctor or nurse if there is any possibility that you may be pregnant.

The procedure

• The procedure is carried out under x-ray screening. This allows the doctor to identify the specific level to be treated.

• A self adhesive foil plate will be placed on your thigh. This is connected to the radiofrequency machine to make an electric circuit.

• Once you are lying in the correct position the doctor will clean your neck / back with an antiseptic solution which may feel cold.

• A local anaesthetic is injected at the site of the procedure. This may sting initially, before the skin goes numb.

• It important that you keep still during the procedure as a special hollow needle will be carefully inserted under x-ray control into the correct position. A very thin wire will then be

threaded down the needle.

• The doctor may ask you to say when you can feel a mild pain or twitching sensation as the machine settings are adjusted. This is very important as it makes sure that the tip of the needle is in the right place.

• The machine settings will then be set to cauterise the nerve by heating it for about one and half minutes. During this period, you may experience some pain at the site of the procedure.

• This process may be repeated at different levels on the neck / back.

• A small dressing may be placed over the needle insertion sites. This can be removed in the evening.

Following the procedure

• After the procedure you will be taken to an area to recover.

• The nursing staff will observe you before going home.

• Please be careful when you first get out of the trolley – ensure you are steady on your feet.

• Take your regular medication and pain killers as normal.

• There can be an initial exacerbation of discomfort before you start experiencing the pain relief. During

this period, you may need to increase your pain killers or require stronger pain killers.

Please ensure that you have arranged for someone to drive you home after this procedure.

The information in this leaflet is not intended to replace your doctor's advice. If you require more information or have any questions, please speak to you doctor prior to the consent for the procedure.