Radiofrequency Neurolysis of Facet Joint

by Jacob Erdei - Date: 2007-05-23 - Word Count: 607 Share This!

What is radiofrequency ablation (RFA)?

Radiofrequency is a means of interrupting pain signals. An electrical current produced by radio waves is used to heat up a small area of nerve tissue, thereby decreasing pain signals from that specific area supplied by that nerve. The nerve facet joint is the target for RFA. Clinical data shows that radiofrequency ablation can effectively provide lasting pain relief.

Contraindications to the procedure

Infection in the area to be injected, current use of blood thinners (anticoagulants)

Before the Radiofrequency Facet Joint Procedure

You will be evaluated. The procedure should be explained in detail by the doctor, including possible complications and side effects and any questions you have will be answered at this time.
Discontinue aspirin, non-steroidal anti-inflammatories and blood thinners (anticoagulants) 3 days before the procedure.

The Day of the Radiofrequency Facet Joint Procedure

Discontinue both clear liquids and food at least 6 hours before the procedure
Continue to take all your medications (including pain medication) with only sips of water up until 4 hours before the procedure
Bring all medication with you so you can take it after the procedure
Do not discontinue any medication without first consulting with your primary or referring physician
If you have diabetes and use insulin, you must adjust the dosage of the insulin the day of the procedure. Your primary care physician will help you with this adjustment. Bring your diabetes medication with you so you can take it after the procedure.
An Intravenous (IV) line will be placed in a vein in your arm prior to the procedure so that you may receive sedative medication during the procedure.
A responsible adult must be present to drive you home as you will be unable to yourself.

During the Radiofrequency Facet Joint Procedure

The procedure takes about 10 - 45 minutes depending on the number of nerves that will be treated.
You will be lying either on your stomach or back during the procedure.
Both local anesthesia and a mild sedative may be used to reduce any discomfort during the procedure.
You will be awake during the process to aid in properly locating the nerve.
After local anesthesia has been administered, your doctor will insert a small needle into a general area where you are experiencing pain.
Using X-ray, your doctor will guide the needle to the exact target area. A microelectrode is then inserted through the needle to begin the stimulation process
During the process, you will be asked by your doctor if you are able to feel a tingling sensation.
The object of the stimulation process is to help your doctor determine if the electrode is in the optimal position for treatment.
Once the needle and electrode placement is verified, a small radiofrequency current is sent through the electrode into the surrounding tissue, causing the tissue to heat up.

After the Radiofrequency Facet Joint Procedure

You will lie down in a recovery room for 30 - 60 minutes for observation.
A nurse will check your blood pressure and pulse.
A bandage may be placed over the injection site.
The nurse will give you a beverage and review your discharge instructions.
You will be given a pain diary to complete prior to your follow-up appointment.
You may experience localized back and or leg pain for several days to weeks after the procedure
Post-injection physical therapy may be required to stabilize the facet joint
If there are any problems after the procedure call your Pain Specialist.

The information provided here varies depending on what pain doctor you go to. Also ask the performing physician what the procedure will entail. This is article is meant to be a guide for Radiofrequency and the exact procedure will vary from doctor to doctor.

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