Also referred to as Radiofrequency (RF) Rhizotomy, the thoracic facet radiofrequency neurotomy is a procedure that is minimally-invasive in nature and its primary aim is to either relieve or completely eliminate the pain emanating from the impaired facet joints. This is done by creating a disruption in the movement of the pain signals via the medial branch nerves. Local anesthetics are used for this procedure.
Prior to the commencement of the procedure, the patient is required to lie face down on the table and the back is sterilized with antiseptic solution. Local anesthetic is then applied in order to numb the area right down to to the spinal column.
With the assistance of a fluoroscope, a small tube that looks like a needle, known as a cannula, is properly guided and positioned, close in proximity, by the medial branch nerves. Once the cannula is inserted into position, a radiofrequency electrode is administered via the cannula into the impaired facet joint where the pain exists. In order to determine whether the electrode is placed in the correct position, a weak electric jolt will be emitted. Should the pain be recreated due to the stimulation, without causing any other muscular effects, then the electrode is in its correct placement.
The electrode, once administered, will heat and burn off the nerve. By doing so, the nerves ability to properly communicate with the brain is disrupted. This prevents pain signals from traveling to the brain and creating pain sensation that would otherwise be felt by the patient. Depending on the situation, multiple medial branch nerves may be treated.
Once the procedure has been completed, both the cannula and the electrode are removed. While the patient may expect to experience a slight increase in pain in the subsequent week following the procedure, the patient will experience pain relief approximately a month after the procedure has taken place. In terms of duration, compared to the steroid block injection procedures, procedures using radiofrequency neurotomies can last for a longer period of time which for some patients can be up to a year while for others, for more than a year.