Medial Branch Radiofrequency Rhizotomy is a procedure which causes an interruption of the nerve supply to a facet joint. This interruption, known as a denervation, is accomplished by a radio frequency probe that heats the two small nerve branches to each facet joint. These nerves are called the medial branches.
This procedure is a follow-up to a Medial Branch Block. Once the source of your pain is isolated with MMB, this Radiofrequency Rhizotomy will provide an extended period of pain relief.
Frequently Asked Questions About Medial Branch Radiofrequency Rhizotomy
Who will perform the radiofrequency rhizotomy and how is it done?
The Radiofrequency Rhizotomy will be performed by a pain medicine specialist trained in chronic pain therapy and assisted by a trained clinician. A local skin anesthetic is given. With fluoroscopic guidance, 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 degrees C for 90 seconds. At least two branches for each joint are treated in the same manner.
How long does it take?
It will take less than an hour, for the actual procedure.
What should I expect?
You will be prepped and taken to a procedure room. You will be positioned lying on your stomach and the area of focus will be cleansed with a sterile solution. The area will be numbed with an injection of lidocaine. Many describe a burning or stinging sensation for a few seconds. The probe will be fluoroscopically guided and placed. A very small electrical current will be passed through the probe. This is not painful. You will only feel a slight tightness, pressure or tingle. When the desired area has been located, the nerve will be bathed in a numbing medication before the cauterization begins.
Will it work immediately?
Most will experience a sunburn-like feeling for about three weeks. Following the Radiofrequency Rhizotomy, there is a 60% chance of pain relief. This typically lasts for three months to one year. The nerve eventually grows back and the procedure may be repeated. While the patient experiences the pain relief. Vigorous physical therapy is necessary to try and strengthen the involved joints.
How should I prepare for the injection?
You may eat lightly before the procedure; ARRANGE FOR A DRIVER TO TAKE YOU HOME. Your procedure will be rescheduled if you do not have a driver; Notify the nurse if you are taking blood thinner, Aspirin or an anti-inflammatory or have an infection or are sick; Stop taking Aspirin seven days in advance; and four days for anti-inflammatories, and Plavix. Blood will need to be drawn prior to procedure to make sure it is not too thin. DO NOT TAKE ANY PAIN MEDICATION THE DAY OF THE PROCEDURE. You may take your routine medication the day of the procedure (heart, diabetes, blood pressure). Expect to be at the office one to three hours. This includes registration, paperwork, review of consent, procedure, recovery and review of discharge instructions.