What Is It?
Facet neurotomy / rhizotomy is a procedure which results in the interruption of the nerve supply to a facet joint. This interruption, known as denervation, is accomplished with the use of a radiofrequency probe that heats the two small nerve branches to each facet joint. These nerve branches are called medial branches.


How Is It Done?
With the patient in a prone position and under fluoroscopic guidance and local anesthesia, a radiofrequency needle is advanced to the base of the transverse processes. The needle is placed along the course of the medial branch. The needle is heated to 80°C for 90 seconds. At least two branches for each joint are treated in this same manner.


Expected Results?
Increased localized back and/or leg pain can be expected from several days to several weeks, and rarely several months, after the procedure. Destabilization of the facet joint is a risk and post-injection training to strengthen the extensor muscles can prevent this possibility.

Following the neurotomy / rhizotomy, there is a 60% chance of pain relief. This typically lasts for three months to 1½ years. The nerve eventually grows back and the procedure can be repeated. While the patient is experiencing pain relief, vigorous physical therapy is necessary to try and strengthen the involved facet joint(s).


How Long Does It Take?
The neurotomy / rhizotomy takes 10 to 45 minutes, depending on the number of levels to be done. The patient is then recovered in the observation area for 30 minutes to 1 hour.

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