Facets are small joints located up and down the back of the spine (also see the facet injection information sheet). If a diagnosis of Facet Syndrome is confirmed (i.e painful facet joints are determined to be the source of back and leg pain) the Radiofrequency Neurolysis (RF) procedure may be appropriate.
In an RF procedure, the small nerves leading to the facet joints are ablated with radiofrequency energy, thus deactivating these nerves and abolishing pain from the joints. Radiofrequency energy is similar to that found in a household microwave oven and allows pinpoint accuracy of delivering the energy only to the intended site.
In the procedure the nerves are located by using mild electrical current and stimulating the nerves. The RF is done with a thin needle after a local anesthetic is used to minimize pain. Sedation is available if the provider recommends it or upon request. The needle is guided into place using an x-ray unit (fluoroscope). The ablation itself takes approximately 2 minutes once the needle tip is in place.
The procedure is very minimally painful. The entire procedure takes approximately 30-60 minutes. Although it is not mandatory unless sedation will be given, please try to arrange for someone to drive you both to and from the appointment for your comfort. If you are taking certain medications you may be advised to stop any blood thinners 7 days prior to RF procedure or NSAIDS (i.e. Motrin, Ibuprofen, Advil, Aleve) 3 days prior to RF procedure. Ice for the first 24 hours can be used to lessen any pain. It is advised that you rest the remainder of the day and may return to normal activities the next day. You will be given specific post-procedure instructions at the time of the RF procedure.
Complications are extremely unlikely. Usually the worse possible outcome is inadequate pain relief. Nevertheless, published complications include bleeding, infection and inadvertent nerve damage.
Success rates vary from 60%-80% in the literature. Although the small nerves will be permanently destroyed it is likely that new nerves may grow back. However, most patients do not require a repeat RF procedure in the future. Overall pain relief will last anywhere from 34 months to permanently.