Cervical and Lumbar Facet RFA: Evidence and Indications

Abstract

Prevalence of facet joint pain increases in the population with age, type of work and activities. Symptoms are more often mechanical with pain increasing with mobility (rotation and bending). Whenever usual conservative treatment (including medication and physiotherapy) fails, interventional treatment has to be considered, including steroid injection as a first step. Whenever steroids are contraindicated or the injection is governed by short-term pain relief, radiofrequency denervation of the painful facet joint can be considered. In the cervical spine, facet joint denervation is performed on ambulatory basis with or without sedation depending on operator’s preference. Two types of radiofrequency denervation can be performed: continuous (thermic) or pulsed neurolysis. Sensory and motor tests are performed to evaluate proximity of medial branches and safety position of the needle away from the motor nerve.