What is Cervical Facet Radiofrequency Neurotomy?
Cervical facet radiofrequency neurotomy explained by Denver, Golden, Aurora, Boulder, Broomfield, Jefferson, and Littleton Colorado’s top pain doctors
Cervical facet radiofrequency neurotomy is a non-surgical, simple treatment used for relieving nerve pain. Studies have shown that more than 75% of people will encounter some type of acute neck or back pain during their life. When patients experience pain originating from the neck or back, it can be triggered by numerous health conditions such as a pinched nerve, a herniated disc, injury, or severe trauma. There are numerous treatment options to relieve pain caused by these ailments, with cervical facet radiofrequency neurotomy being one of the best for patients who experience pain deriving from the facet joints.
Reports show that cervical facet radiofrequency neurotomy treatments are highly successful with decreasing or eliminating a patient’s nerve pain. Longitudinal studies show that the majority of patients who undergo this type of treatment see a reduction in symptoms lasting from a few months to a few years.
How is Cervical Facet Radiofrequency Neurotomy Performed?
Located on both sides of the spine are the body’s facet joints. Due to their contour, the facet joints have restricted mobility. In comparison, the cervical facet joints, which are located in the neck region, are shaped in a distinct way that allows for a greater range of motion. The spinal cord is located in the spinal canal, and operates as the major information passageway from the brain to all the parts of the body. In addition, the medial nerves, which are thought to communicate signals between the facet joints and the brain, are located in this area. Damage or injury to any of these joints can cause pain, inflammation, stiffness, or tenderness in the neck and upper back.
Known to effectively reduce or eliminate pain, cervical facet radiofrequency neurotomy disrupts the medial nerve from communicating pain signals to the brain. This outpatient procedure typically takes about an hour, so the patient will be able to go home once the treatment is completed. A physician will use a topical anesthetic and fluoroscope (X-ray guide) to insert a very small radiofrequency needle into the problematic nerve. Once the needle is inserted, a tiny conductor is threaded through to the nerve.
In order to ensure correct placement, the physician will run a radio wave through the conductor, causing the nerve to temporarily set off pain signals. The precise placement of the conductor is confirmed when the muscle twitches in response to the radio wave finding the targeted nerve. The physician will then numb the nerve before administering a strong amount of heat. The use of heat helps to impair the medial nerve, cauterizing and creating an abrasion directly on the area triggering the pain. The abrasion in return successfully disrupts the medial nerve from transmitting indications of pain back to the brain.
After the procedure, the physician will monitor the patient for approximately thirty minutes to check for any adverse side effects from the treatment. Common side effects are temporary numbness and tenderness near the injection area. Since injured nerves can take a few weeks to completely expire, patients will frequently experience symptoms of tenderness and numbness throughout this period of time. In some cases, the physician will prescribe medication to the patient to assist with the pain symptoms during the recovery period.
Conditions Related to Cervical Facet Radiofrequency Neurotomy
The main goal with this type of treatment is to reduce pain symptoms in the neck and back that haven’t been sufficiently relieved by other means, such as physical therapy or prescribed medication. Patients most likely will find relief from cervical facet radiofrequency neurotomy if they successfully experience temporary relief in pain symptoms following a localized anaesthetic block of the nerves that distribute to the cervical facet joints.
A simple and safe treatment option for patients suffering from nerve pain originating from the facet joints is cervical facet radiofrequency neurotomy. It is an outpatient procedure that can be administered with minimal side effects. Radiofrequency waves are used to disrupt the cervical medial branch nerve so that pain from the irritated joint cannot be transmitted to the brain. Longitudinal studies have shown that the effects of cervical facet radiofrequency neurotomy can provide a patient with pain relief for a few months up to a few years.
- Cohen SP, Husang JH, Brummett C. Facet joint pain – advances in patient selection and treatment. Nat Rev Rheumatol. 2013;9(2):101-16.
- Davis CG. Mechanisms of chronic pain from whiplash injury. J Forensic Leg Med. 2013;20(2):74-85.
- Falco FJ, Datta S, Manchikanti L, Sehgal N, Geffert S, Singh V, Smith HS, Boswell MV. An updated review of the diagnostic utility of cervical facet joint injections. Pain Physician. 2012;15(6):E807-38.
- Falco FJ, Manchikanti L, Datta S, Wargo BW, Geffert S, Bryce DA, Atluri S, Singh V, Benyamin RM, Sehgal N, Ward SP, Helm S, Gupta S, Boswell MV. Systematic review of the therapeutic effectiveness of cervical facet joint interventions: An update. Pain Physician. 2012;15(6):E839-68. Review.
- Husted DS, Orton D, Schofferman J, Kine G. Effectiveness of repeated radiofrequency neurotomy for cervical facet joint pain. J of Spinal Disorders & Techniques. 2008;21(6):406-408.
- Lord SM, Bogduk N. Radiofrequency procedures in chronic pain. Best Pract Res Clin Anaesthesiol 2002; 16: 597–617.
- McDonald GJ, Lord SM, Bogduk N. Long-term follow-up of patients treated with cervical radiofrequency neurotomy for chronic neck pain. Neurosurgery. 1999;45:61-68.
- Mukai A, Kancherla V. Interventional procedures for cervical pain. Phys Med Rehabil Clin N Am. 2011;22(3):539-49.
- Van Eerd M, de Meij N, Dortangs E, Kessels A, can Zundert J, Lataster A, Patijn J, van Kleef M. Long-term follow-up of cervical facet medial branch radiofrequency treatment with the single posterior-lateral approach: An exploratory study. Pain Pract. 2013;18[Epub ahead of print].
- Voorhies RM: Managing the more common cervical disorders. Intern Med 1996; 17:18-41.