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How Are Facet Joint Injuries Treated? Radiofrequency (RF) Rhizotomy with Denervation

In our previous article we discussed facet joint syndrome secondary to whiplash injuries from car accidents going underdiagnosed by doctors. The result is that injury accident victims suffer unnecessarily when treatment for the facet joint injury can be easily diagnosed via steroid injections. The next question, is how to treat facet joint injuries and provide the patient with pain relief.

Unfortunately, treatment for primary facet pain is not as easy as a diagnosis. Options always include physical therapy for lumbar stabilization and strengthening. Intra-articular steroid injections can aid in recovery during the painful period. A patient with primary facet pain, prove with either one or more medial ranch blocks, may be a candidate for a facet rhizotomy using phenol or radiofrequency (RF). The patients selected for rhizotomy are those who are not surgical candidates and who have failed other conservative measures hearing. By using the radiofrequency rhizotomy, the surgeon denervates the medial nerve which runs along the posterior spine near the facet joints. Radiofrequency rhizotomy reportedly allows the medial branch to regrow within six months to two years; regrowth is less frequent with phenol.

Chronic benign cervical pain syndromes, not emanating from any objective anatomical cause, are often difficult to treat surgically. Treating doctors and surgeons do, however, have a wide variety of options to assist and help their patients. These include epidural injections and radiofrequency rhizotomy and denervation.

Facet rhizotomy and denervation is actually more common than you think. During the 2009-2010 basketball season, Los Angeles Laker Luke Walton underwent facet rhizotomy to eliminate back pain. The procedure was successful, but kept Luke off the court for six weeks.


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