Cervical Facet Joint Radiofrequency Denervation

Cervical Facet Joint Radiofrequency Denervation

The procedure known as cervical facet joint denervation is a long term means of blocking pain that originates from the cervical facet joints.  These joints are the ones responsible for the cervical spine (at the neck and top of spine) being able to rotate as well as bending forwards and backwards.

Often these joints can degenerate with age or with injury and can cause a great deal of pain.

Conventional and non surgical treatments include nerve blocks (blocking the nerves from sending pain signals to the brain as well as physiotherapy and painkillers.  Nerve root blocks tend to be successful, but the pain may come back.  If patients respond well to the blocks then radiofrequency denervation may be considered as a long term means of ensuring that the pain is alleviated and does not return.

Denervation; The Procedure

As the name suggests, facet joint denervation is a way of permanently stopping the pain by preventing the nerve from sending pain signals to the brain. 

The nerve is desensitised by the use of radiofrequency to render the nerve inactive.  This means that it will no longer feel anything on a permanent basis, so it is not a procedure that is done without due consideration.

The denervation is carried out after a patient has been given a sedative and then a local anaesthetic is also administered.  A needle will then be inserted, with X-ray being used to guide the needle to where the radiofrequency needs to be administered. 

Tests will also be carried out to ensure that the needle is as close as possible to where it is needed to be.  The radiofrequency is then administered and the nerve is effectively ‘destroyed’ by the radiofrequency heating it to around 80˚C to ensure that the nerve will have a permanent lesion and thus be ineffective in transmitting pain signals.

Due to the need for the procedure to be exact and treat only the nerve or nerves that cause pain, precision is required and so great care has to be exercised to ensure that the needle is accurately positioned.

Some patients do find the procedure painful because the nerve is obviously active until the lesioning takes place.  Sedation helps overcome the pain and the radiofrequency itself lasts for only 60 to 90 seconds, although the positioning of the needle, tests etc as well as setting up the X-ray and so on does require longer, since the need for accuracy is vital.

After The Procedure

Most people are able to return home after only a few hours, so unless they live alone, there is no need for an overnight stay in hospital.  Some people also find that they experience some pain or even increased pain for one or two weeks after the denervation has taken place, but increasing the use of painkillers can usually enable patients to control this pain.  After a fortnight or so the nerve will be completely inactive and the pain will be eradicated, leaving the patient able to return to a pain free existence.

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