Cervical Medial Branch Thermal Radiofrequency Neurotomy

The facet joints or zygapophyseal joints are a set of joints between the articular processes of two adjacent vertebrae. The cervical facet joints provide support, stability and mobility to the cervical vertebrae, especially on extending, bending and rotation of the neck area. Similar to other joints in the body, these joints are vulnerable to inflammation and degeneration. The cervical medial branch nerves are very small nerves that supply the facet joints in the cervical spine. They transmit pain signals from the facet joints to the brain. These nerves hurt when facet joints are injured or diseased.

Once patients have shown significant temporary relief after the medial branch nerve blocks, they are candidates for the radiofrequency procedure. Under X-ray guidance, small radiofrequency cannulae are placed very close to the small cervical medial branch nerves and heat energy is used to coagulate them. The purpose of this procedure is to interrupt the pain signal to the brain, while preserving other functions, such as normal sensation and muscle strength. Since these small nerves eventually grow back, symptoms may return.

References

  1. Theodoridis T., Kraemer J.: Injektionstherapie an der Wirbelsäule. Manual und Atlas. 3. Auflage. Thieme 2017.
  2. Bogduk N.: Practice Guidelines for Spinal Diagnostic and Treatment Procedures. 2. Edition. International Spine Intervention Society 2013.