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Radiofrequency denervation to facet joints

What is Radiofrequency denervation ?

This procedure burns the nerve supplying the facet joint, to provide long lasting relief for those with facet joint arthritis.

Who can have the procedure
  • This procedure is  used for those with a diagnosis of facet joint arthritis based upon good response to medial branch blocks to the facet joints
  • Particularly good in neck pain and low back pain
How many people benefit

Initial response rates are 70%.  In the longer term this procedure works in 50% of patients who continue to experience more than 50% benefit.  For approximately 3 months after the procedure the patient may experience increased pain, during this time extra analgesia may be required and I normally recommend physiotherapy.  The chance of being worse off in the longer term is less than 1%.  Patients may experience long term numbness and occasionally soreness in the back which is usually of no consequence.  Local anaesthetic and steroids are used to help cover post-operative soreness and these may cause headaches for a few days, occasionally associated with temporary weight gain .

Before the procedure
  • Radiofrequency denervation procedures are done as a day case procedure.
  • Do not eat 6 hours before your procedure.
  • You can drink water up to 2 hours prior to the procedure
  • Continue all regular medications except blood thinning medications such as clopidogrel or warfarin.
  • For clopidogrel stop the medication 10 days prior to the procedure
  • For warfarin, stop the medication 5 days prior to the procedure and have a blood test 24 hours prior to the injection at your local anti coagulation clinic
During the procedure
  • During the procedure you will lie on your tummy.
  • You will be offered some sedation to minimise any pain during the procedure.
  • Local anaesthetic is injected into the skin
  • Under x-ray control needles are placed at the back of the spine (approximately 3 per side).
  • The nerves are stimulated using a special machine to locate the medial branch nerve and avoid the nerve that controls the function of your legs.
  • The procedure takes about 60 minutes to perform and does cause some discomfort – but this will be controlled during the procedure.
  • Steroid and local anaesthetic is injected after the denervation procedure to reduce post-operative discomfort.
After the procedure
  • You will be in the recovery room for about 60 minutes
  • You will need someone to drive you home
  • It is common to experience an increase in pain for 2 weeks as the nerves become irritated before dying off.  Take regular pain relief and use cold packs applied to the area in this time.
  • We rarely see any problems with these injections
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