Surgeons commonly use radiofrequency (heat) energy to cut small sensory nerves around the facet (spinal) joints that are causing patients' low back pain. The procedure is called a radiofrequency denervation (RFD).
patients are carefully selected for this treatment. The pain generating spinal structure must be proven to be the facet joint. Facet joints can be identified as the primary cause of back pain by using fluoroscopic-guided nerve blocks. In this procedure, the surgeon uses special imaging (fluoroscopy) that allows him or her to see inside the body.
A local anesthetic (numbing agent) is injected around the nerve of the suspected facet joint. If more than 50 per cent of the patient's pain is relieved, the test is considered positive. A positive test means that the facet joint tested is causing the low back pain. The diagnostic facet joint block may be repeated a second time with the same results before patients are treated with radiofrequency denervation.
Once the bothersome facet joint is identified, then radiofrequency denervation can be done. The irritated nerve causing chronic pain signals is burned for 90 seconds at a high temperature (around 175-degrees Fahrenheit). A special probe is used to burn the nerve in three separate places. The result is to completely denervate (cut) the nerve and interrupt pain messages.
Robert S. Burnham, MSc, MD, FRCPC, et al. A Prospective Outcome Study on the Effects of Facet Joint Radiofrequency Denervation on Pain, Analgesic Intake, Disability, Satisfaction, Cost, and Employment. In Archives of Physical Medicine and Rehabilitation. February 2009. Vol. 90. No. 2. Pp. 201-205.'