Lumbar Facet Radiofrequency Neurotomy is also known as lumbar facet thermal coagulation or rhizotomy. A lumbar radiofrequency ablation (RFA) is an outpatient procedure for treating lower back pain.
The lower area of the spine is called the lumbar region. It contains five vertebrae, which connect with each other by the facet joints. The facet joints are found on both sides of the spine.
The medial branch nerves are found near facet joints and they provide nerve supply to the facet joints. When the joints are injured, the medial branch nerves send a signal to the brain that the joint is injured.
You may feel pain if a lumbar facet joint is injured, which may feel like muscle tension. You may have pain in one or more of these areas, and it may last longer than two months.
The common tests that are usually done include such as x-rays or MRIs which may not show if a facet joint is causing pain. The best way to diagnose facet pain is to block the pain signal in a medial branch nerve with a local anesthetic.
Radiofrequency Neurotomy uses energy to disrupt the nerve function. During the procedure, the medial branch nerve that supplies the facet joints is targeted. Once the nerve is disrupted, it can no longer transmit pain from the injured facet joint.
During the procedure
The physician numbs your skin with local anesthetic. Under X-ray guidance, a thin needle is advance near the facet joint. To ensure proper placement of the needle, the physician will stimulate the nerve, which may cause muscle twitching and provoke some of your pain.
Once proper position has been confirmed, the nerve is numbed with local anesthetic. The radiofrequency energy is then use to disrupt the medial branch nerve. The procedure will be repeated for each additional level.
After the procedure
You will be monitored for a half an hour after the Lumbar RFA. When you are ready to leave, the staff will give you discharge instructions.
You may feel sore for a few days. You should take it easy for the rest of the day. You will most likely experience maximum pain relief in two to three weeks.
The medial branch nerves regenerate after an RFA, but how long this takes varies. Your pain may or may not return when the nerves regenerate. If it does, another RFA can be done.