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Cervical Facet Joint Radiofrequency Rhizotomy

What does “Cervical Radiofrequency Facet Joint Rhizotomy” mean?

Here is the meaning of each word:

  1. Cervical: the part of the spine located in the neck
  2. Facet Joint: small joint on the back of the spine
  3. Radiofrequency: a form of energy which can produce targeted heat
  4. Rhizotomy: to disrupt a nerve

Altogether, “Cervical Radiofrequency Facet Joint Rhizotomy” means disrupting the small nerves traveling to the facet joint in the neck with targeted heat energy.

Why is a Cervical Radiofrequency Facet Joint Rhizotomy done?

This procedure is often done to relieve pain from an inflamed facet joint. The hope is that this procedure may last longer than a steroid injection of the facet joint.

What is the difference between a Cervical Facet Joint Injection, a cervical medial branch block and a Cervical Radiofrequency Facet Joint Rhizotomy?

  1. A Cervical Medial Branch Block is an injection which uses local anesthetic to anesthetize the nerves traveling to the facet joint. This is done to help diagnose if the pain is coming from the facet joint.
  2. A Cervical Facet Joint Injection is done to deliver medication into the facet joint to help with pain and inflammation.
  3. A Cervical Radiofrequency Rhizotomy of the Facet Joint uses targeted heat energy to disrupt the small nerves traveling to the facet joint. The goal is to provide the patient with long lasting pain relief.

How is a Cervical Facet Joint Rhizotomy done?

Here are the steps of how the procedure is done:

  1. The patient is brought to a Procedure Room or Operating Room.
  2. An intravenous catheter (IV) may be placed and relaxing medication is often given (sedation).
  3. The patient is placed on their stomach (prone) or on their back (supine) with the head turned. This depends on the doctor’s preference.
  4. The neck is then cleaned with surgical antiseptic and sheets (drapes) are placed around the site to keep it clean.
  5. An X-Ray machine (C-Arm) is then used to see the facet joints.
  6. Local anesthetic medication is injected under the skin.
  7. A specialized needle (radiofrequency needle) is then placed through the anesthetized skin and advanced to a location next to each facet joint (lateral pillars). This is done with the help of the X-Ray machine.
  8. The specialized needles are hooked up to a radiofrequency generator.
  9. The radiofrequency generator is turned to a certain frequency which sends impulses to the nerve. This frequency stimulates the nerve and gives the patient a similar sensation than their usual symptoms. This may be felt as slight pain, tingling, or pressure.
  10. Next, the radiofrequency generator is turned to a different frequency. On this frequency, the larger nerves which give you movement (motor) are tested. The doctor does not want the specialized needle (radiofrequency needle) to be close to these nerves. This test should not move the muscles to the shoulder and arm.
  11. Now, the radiofrequency generator is turned to a setting where it can deliver a very targeted radiofrequency energy in the form of heat. The doctor choses the temperature and the time interval of how long this temperature is delivered to the nerve. Just prior to delivering the heat energy, the doctor often injects a local anesthetic onto the nerve to lessen any discomfort.
  12. Once all the nerves are treated in this fashion, the needles are withdrawn.
  13. Sterile band-aids are placed over each injection site.
  14. The patient is then taken to a Recovery Area for observation.

How long does it take to do a Cervical Facet Joint Radiofrequency Rhizotomy?

Depending on how many spinal levels have to be treated, the procedure can take 15-30 minutes or more.

How much benefit can patients gain from a Cervical Facet Joint Radiofrequency Rhizotomy?

The benefit from this procedure can vary. Patients who respond well can have pain relief for 6 months or more.