Treatment

CERVICAL RADIOFREQUENCY RHIZOTOMY (RFR)

(This is the section that explains the detail of the operation or procedure above and should be read in conjunction with the section Your Neck Operation).

A cervical RFR is performed for pain that is caused by damaged facet joints (see the section Anatomy of the Spine). The aim of the operation is to temporarily paralyse the very small nerves that supply the facet joint of pain sensation. This will then bring partial or complete (but temporary) relief of the pain, spasms and referred pain that these damaged facet joints can cause.

The reason why your specialist performs this procedure and not a more invasive operation is because he or she is trying to be as conservative as possible in treating your condition. The aim is to treat your symptoms without resorting to a more invasive operation.

When undergoing this procedure, you will be lying on your stomach on bolsters or pillows. Some specialists perform this procedure with their patients lying on their back. Your specialist will use an X-ray machine to guide the needles that are used to do the procedure with.

In performing the rhizotomy, thin needles are inserted through the skin at the back of the neck. These needles are placed on the small nerves that supply the joints between the two vertebral bodies and a radiofrequency generator is then attached and the nerve is inactivated by radiofrequency pulses.

These are not majorly important nerves and it is not dangerous to inactivate them with radiofrequency pulses. When inactivated, these nerves cannot conduct pain sensations from the joint to the brain. This means that the pain sensation from the facet joints decrease or clear up completely. This is, however, a temporary effect and the treatment will have to be repeated when the pain returns.

The treatment can either be a pulsed radiofrequency procedure, where the nerve is inactivated by pulses of radiofrequency current or it can be a thermal lesion where the nerve is damaged by heat generated by the radiofrequency current. Thermal lesions last longer, but may have more complications than pulsed procedures.

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This is a photo of the side of a cervical spine. Note the black spots that indicate the area where the needles are placed to inactivate the nerves that supply the joint with pain sensation.

The needles are placed with the aid of an X-ray machine and a radiofrequency current is passed through an electrode that is fitted into the needles. This is a relatively safe procedure. Pulsed radiofrequency is a safer procedure than conventional radiofrequency procedures. Pulsed radiofrequency stuns the nerve whereas conventional radiofrequency treatment is based on temperature mediated damage of the nerve.

Ward care

You may sometimes have a bit of discomfort directly after the procedure, but this will clear up very soon. You will be allowed to move around freely after your procedure.

Discharge

This procedure is usually performed as a day procedure and you will be allowed to go home soon after your procedure.

Rehabilitation

It is incredibly important to get a lot of rest and exercise following your procedure. It is frequently useful to supplement your treatment with physiotherapy and local treatment such as massage therapy and chiropractic treatment.

Follow-up

It is incredibly important to get a lot of rest and exercise following your procedure. It is frequently useful to supplement your treatment with physiotherapy and local treatment such as massage therapy and chiropractic treatment.