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Facet Denervation (Rhyzolysis) (Percutaneous Denervation of the Facet Joint by Radiofrequency Waves)

This procedure is indicated in patients with spinal pain relieved temporarily by facet joint blocks.
 
The procedure involves positioning of a small probe, similar to a large needle,  just lateral to the facet joint in the area of emergence of the median branch of the posterior primary ramus (nerve) which supplies sensation to the facet joint. It is carried out under local anaesthetic and  neuroleptic intravenous sedation.
 
The surgeon or physician performing the procedure uses an image intensifier (fluoroscopy) to monitor the accurate positioning of the probe.
 
The probe is left for approximately two minutes near each selected joint and the radiofrequency wave produces a controlled temperature of up to 90° centigrade at the probe tip which “numbs” the small nerves supplying the chosen facet joint.
 
Following the procedure the patient is discharged an hour or so later with a small dressing over the site of entry of the probe and which is generally kept for three days.
 
The procedure may result in temporary exacerbation of back pain for a few days.  Due to use of local anaesthetic patients can also experience temporary numbness or weakness in one or both legs.
 
Approximately 80% of appropriately selected patients will experience improvement of their spinal pain for a period of between six to eighteen months.
 
The procedure should in general terms, be considered extremely safe and in Dr.Osti's personal experience of over five thousand cases, no permanent nerve damage or other serious complications have been recorded.
 
The main risk is, in part,  temporary exacerbation of pain following the procedure and/or as previously mentioned, the possibility of temporary leg numbness and/or weakness induced by the local anaesthetic.
 
If successful for at least six months facet rhyzolysis can be repeated on a yearly basis with constant results and no increase in risk.



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