Cervical Facet Radiofrequency Neurotomy

What are Cervical Facet Joints?

The paired joints in the neck are referred to as cervical facet joints. They are supplied by nerves that carry pain signals to the brain and spinal cord.

What is Cervical Facet Radiofrequency Neurotomy?

Cervical facet radiofrequency neurotomy (RFN), also called medial branch RFN, is a minimally invasive procedure for the management and control of chronic neck pain. It works by targeting the medial branch nerves and then inactivating them through heat supplied from electric currents delivered via radiofrequency electrodes. This process is termed electrocauterization. This makes the medial branch nerve incapable of transmitting pain signals.

The medial branch nerves carry pain signals from your neck to your brain and are responsible for pain sensation in your neck.

What are the Benefits and Advantages of Cervical Facet Radiofrequency Neurotomy?

Cervical facet radiofrequency neurotomy is a simple procedure. Its advantages include:

Does not require hospitalization
Performed as an out-patient procedure
Pain relief may last 3 to 18 months depending on the individual undergoing the procedure and their overall health condition, pain intensity, and pain response.

Radiofrequency neurotomy needs to be repeated if you have recurrent episodes of neck pain.

What are the Indications for Cervical Facet Radiofrequency Neurotomy?

Cervical facet radiofrequency neurotomy is commonly recommended for chronic neck pain, also called cervical facet joint pain. It can also be used for the treatment of whiplash.

What is the Procedure for Cervical Facet Radiofrequency Neurotomy?

A cervical facet radiofrequency neurotomy is performed as an outpatient procedure.

You will be placed on the X-ray table in prone position (on your stomach).
Your physician will clean the intended site on your neck with antiseptic and cover it with a sterile drape.
You may be administered anti-anxiety medication before the procedure to keep you relaxed.

Cervical facet radiofrequency neurotomy involves two steps:

Locating the medial branch nerves:

A local anesthetic is injected into the cervical facet joint to numb the neck, shoulder, and downwards towards the spinal column. You may feel a burning or stinging sensation for a few seconds.
Under fluoroscopic guidance (live X-ray) a thin tube called the cannula is carefully introduced into the irritated medial branch nerves.
Then, your doctor inserts a radiofrequency electrode through the cannula and administers a weak electric current to your medial branch nerves. This is done to ensure the electrode is placed correctly.
The nerve sends a pain sensation causing a muscle twitch which indicates the electrode is positioned properly.

After identifying the location of the medial branch nerves, your doctor proceeds to the electrocauterization step.

Medial branch nerve electrocauterization:

The general steps for electrocauterization include:

After placing the electrode correctly, a numbing medication is administered through the cannula to the targeted nerve to prepare for the electrical treatment.
An electric current is passed through the electrode.
The nerve develops a lesion and is rendered inactive for pain transmission.
After this, the electric supply is turned off.
The electrode and cannula are removed.
The injection site is covered with a bandage.

You will be monitored for several minutes before you are discharged.

Care and Recovery After a Cervical Facet Radiofrequency Neurotomy

Your neck/back pain will improve after cervical facet radiofrequency neurotomy.

After the procedure, you may experience:

Pain around the injection site, for which ice packs can be applied to minimize discomfort.
Numbness for a few days around the injection site. This is normal and will subside gradually.

You should arrange for someone to drive you home after the procedure.

Avoid:

Swimming or soaking in a tub or pool
Application of any form of heat to the injection site for the rest of the day following your procedure

Keep track of the degree of pain relief and its duration. You may be required to go for repeat sessions once the effect of radiofrequency neurotomy begins to wear off and you experience pain.

What are the Risks Associated with a Cervical Facet Radiofrequency Neurotomy?

Cervical facet radiofrequency neurotomy may be associated with the following risks and complications such as:

Damage to the nerves
Numbness or weakness
Severe pain
Infection at the injection site