The purpose of radiofrequency (RF) rhizotomy, or RF neurotomy, is to reduce or eliminate facet joint pain and related symptoms in the neck or low back. The goal of the procedure is to interrupt communication of pain between a specific medial nerve root and the brain. The medial nerve roots innervate the spine's facet joints.
Before a RF rhizotomy is performed, the pain generating facet joint nerve(s) (medial branch nerves) have been identified by means of a diagnostic injection, such as a facet joint or medial branch nerve block. Other tests may include MRI. Since the medial branch nerves do not control neck or low back muscles, it is not harmful to disrupt or turn off their ability to send signals to the brain conceived as pain.
RF neurotomy is a precisely targeted injection that works by creating heat to destroy a facet joint's medial branch nerve. Relief from pain and related symptoms may last a year or longer. However, the medial branch nerve root regenerates (grows back) and facet joint pain may come back. Results vary from patient to patient. For example, if there is instability at the segment where the RF neurotomy is performed, pain relief and its duration is less.
Anterior-posterior fluoroscopic view of a RF neurotomy procedure
Lateral fluoroscopic view of a RF neurotomy procedure
Each vertebra in the cervical (neck), thoracic (chest), and lumbar (low back) has two sets of facet joints at the back of the spine. One pair faces upward and one downward with a joint on the left and right sides of the vertebra. Facet joints are hinge-like and link vertebrae together.
Each facet joint is innervated by a medial branch nerve. The medial branch nerves control sensation to the facet joint. These nerves do not control sensations or muscles in your arms or legs.
Below is a short list of common instructions. After you are seen at Colorado Comprehensive Spine Institute (CCSI), our doctor will provide a more specific list for you.
A radiofrequency rhizotomy, like other medical procedures, may present risks. Complications include risk of infection, low blood pressure, headache, and allergic reaction to medication.
The morning after your radiofrequency rhizotomy, we will follow-up with you by telephone. However, if you have a question, please call our office for prompt assistance. We recommend you record your pain level and symptoms each day in a pain diary. It is very common to experience an increased pain level, or back soreness for a few days after the procedure. Your pain diary will help you provide your doctor with detailed information about your treatment progress during your follow-up office visit.