Facet
Medial Branch Radiofrequency Thermocoagulation - RFTC
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Facet joints are the paired joints that connect
vertebrae in the spine. They are important for both
range of motion and stability.
Over time and with physical stress these joints can
erode, enlarge and become arthritic. Facet arthropathy
can further cause back spasm and referred pain that are
frequently indistinguishable from sciatica or discogenic
radicular pain.
Facet Medial Branches are the small branches of spinal
nerves that innervate these joints. Facet blocks are an
important component injection technique for diagnosing
and treating pain from facet arthropathy.
Facet medial branch blocks help to reduce pain from
joints and muscles and facilitate physical
rehabilitation. Radiofrequency thermocoagulation (RFTC)
medial branch rhizotomy which is used to ablate these
small nerve branches utilized for long-term pain relief.
Introduction
Radiofrequency ablation
or lesioning is a treatment utilizing
radiowaves and heat to destroy tissue, in our
case a nerve, for pain relief. Radiofrequency
has also been used for treating fast heartbeats
and tumors with great success.
Radiofrequency rhizotomy (or RFTC,
radiofrequency thermocoagulation) of the spinal
facet joints provides significant pain relief in
well selected patients with facet joint syndrome
which can include symptoms of neck pain, back
pain, arm pain, gluteal pain and leg pain.
Procedure
 
RFTC
is an outpatient procedure performed under local
anesthesia. Sometimes intravenous sedation is
used to help the patient relax. During the
procedure, radiofrequency waves are transmitted
through the tip of a specialized needle placed
into the facet joint under x-ray guidance. The
heat generated from the needle coagulates the
nerve and renders it non-effective for
transmitting pain impulses – thus providing pain
relief.
After the procedure, the patient will be taken
to the recovery room for a brief period of
monitoring, and for instructions before
discharge.
Risks
RFTC
is a safe, non-surgical treatment. There are a
few possible complications related to RFTC but
the risk is low. Your doctor will glad to
explain the procedure and the risks to you in
detail and answer any question that you may
have.
After Care
Immediately following the procedure, you may
have some local numbing but this will be only
temporary.
You
may experience an increase in pain and/or muscle
spam for the first several days following the
procedure. Additional pain medications or muscle
relaxants may be necessary to help you stay
comfortable.
Drink lots of fluids and eat foods with plenty
of fiber. If constipation should occur you may
need to use an over-the-counter laxative.
You
may notice some swelling and bruising at the
needle sites. Using a cold pack will ease the
discomfort.
You
will be given an instruction sheet on what to do
and whom to call should you have any question or
concern.
Your
doctor will arrange a follow-up appointment or
phone consult within three to four weeks after
the procedure to see how you are doing.
The
degree of pain relief varies from person to
person. The maximum decrease in pain may take up
to three or more weeks to occur. You can
eventually expect 50 percent or greater pain
relief. Pain relief can last from six to12
months, or longer. The nerves do repair
themselves and your pain may return. The
procedure can be repeated if the pain returns
some later time.
Rehabilitation
Why
is rehabilitation important after RFTC?
It
is important that you start a program of
conditioning, strengthening, and range of motion
exercises after radiofrequency ablation.
Ideally, increased muscle strength around the
arthritic joints will make pain relief more
prolonged after radiofrequency ablation. With
rehabilitation, when the nerves do regenerate,
you will not likely experience the same
intensity of pain as before the procedure.
You
may be prescribed a formal physical therapy
program after undergoing the RFTC procedure.
For
more information, or if you should have more
questions, please contact our office to speak to
one of our staff.
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