Radiofrequency Lesioning

Radiofrequency nerve ablation (neurotomy) has a long history in the treatment of spine facet joints. Clinically, pain from facet joints are located along the spine and do not travel to distal extremities. This technique is an emerging therapy for sacroiliac joint pain. At the sacroiliac joint level, the procedures are more complex due to the area's nerve supply variability.

Radiofrequency nerve ablation of facet joints is performed in an operative setting using mild sedation and local anesthetics. Fluoroscopic x-ray guidance allows the physician to accurately position the radiofrequency probe adjacent to the medial branch nerves to be treated. The nerve is then heated to 80C using a radiofrequency generator.

Nerve functions usually recover within 12 months. It has been demonstrated that muscles innervated by these medial branches undergo atrophy following successful denervation. However, patients never complain of weakness or instability following procedure.

A number of studies have been performed on the efficacy of radiofrequency nerve ablation. For example, it has been shown that lumbar radiofrequency nerve ablation is effective for facet joint pain. Medical literatures demonstrated that at 12 months, 60% of patients had 90% relief, and 90% had 60% relief.

Side effects of radiofrequency nerve ablation potentially include:

• Rare, but possible, allergic reaction to local anesthetic.
• Bleeding and bruising; the effects are minimal and should disappear within days.
• Infection, though unlikely.
• Post procedure soreness is extremely variable and dissipates within a few days