Facet Joint Neurotomy

Interventional procedure that alters the function of nerves associated with the painful facet joint to provide long-term relief for facet joint pain.

The basics

Facet joint neurotomies are low-risk interventional procedures used to provide long-term relief for facet joint pain, also called posterior element pain. This procedure alters the function of the nerves associated with the painful facet joint, which stops pain signals originating in the joint from being reported to the brain.

Who's it for?

Facet joint neurotomies are for people who have been diagnosed with facet joint pain through a diagnostic procedure such as a facet joint injection or medial branch block. It is suitable for people who experience significant lower back pain, neck pain, or upper back pain due to facet joint pain.

How it works?

  1. The patient is placed under light anaesthetic sedation.
  2. Imaging is used to place the probes on a nerve associated with the facet joint.
  3. Pulsed radiofrequency or cryotherapy is performed on the nerve.
  4. This process is repeated for each nerve associated with the affected facet joints.
  5. The procedure is completed, and the patient is moved to the recovery room.

Therapies & treatments

Neurotomies tend to be more uncomfortable than other facet joint procedures. Pain may worsen for several days before feeling the procedure's effects. Neurotomies work by altering the function of the nerves, reducing pain. These effects begin to occur after several days and gradually increase over the following four to six weeks. Pulsed radiofrequency neurotomies provide the longest-lasting pain relief, with results generally lasting between one and two years.

Note: In some cases, complex spinal pain will be treated with a combination of facet joint neurotomies and epidural steroid injections, which take two to four weeks to reach their full effect.

Risks & considerations

Common side effects of facet joint neurotomies include local bruising or swelling over the needle site and increased back pain for several days after the procedure. If paired with epidural or steroidal injections, increased sensitivity to pain over the injection areas may be experienced for up to four weeks.

Rare side effects include infection, abnormal bleeding, leg pain or numbness over the site of the facet joint, which could last for weeks to months.

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