Radio frequency nerve lesioning

Radio frequency lesioning is an outpatient procedure using a specialized machine to interrupt nerve conduction on a semi-permanent basis. The nerves are usually blocked for 6-9 months. The procedure is typically used to treat pain of joints in the spine. It is also sometimes known as a facet rhizotomy.

Procedure
The procedure is performed in a fluoroscopy room. Fluroscopy identifies bony landmarks that allows the physician to localize the relevant nerves. Numbing medication is normally injected before the radiofrequency needle is inserted. After confirmation that the needle tip is positioned correctly, an electrode is inserted into the needle. Using electrical stimulation, the correct nerve is identified by the patient in response to a "tingling" or "buzzing" sensation. This sensation does not typically produce any pain.

A small electrical current from the radiofreqeuncy lesion generator (a computer) is passed through the needle. The nerves are treated with precise controls by a physician while the needle is inserted into the body. The tissues surrounding the needle tip are then heated where electric current is passed using the radiofrequency machine for 60 to 120 seconds. This will numb the nerves. The needle is withdrawn and if successful the nerve branches have been denatured to the point where pain-generating signal is interrupted.

Lesioning most commonly occurs at the medial branch nerves of the cervical, lumbar and thoracic spine. This is a common procedure to alleviate back pain brought on by degenerative disc disease, facet arthropathy or generalized facet disease.

Typically, a procedure such as this is preceded by nerve stimulation to confirm accurate localization of the nerves.