Facet joint denervation is a minimally invasive technique used to reduce chronic back or neck pain originating from the small paired joints located along the back of the spine. Rather than repairing or replacing the joint, this approach interrupts the nerve signals responsible for transmitting pain from an arthritic or irritated facet joint, offering a way to manage symptoms when the joint itself remains structurally unchanged.
What Is Facet Arthropathy and Why Does It Hurt?
Facet arthropathy refers to degenerative changes in the facet joints, small stabilizing joints found on either side of each spinal segment that guide and limit motion between vertebrae. Like other joints in the body, facet joints can develop osteoarthritis-type changes over time, involving cartilage breakdown, joint space narrowing, and sometimes bone spur formation. These changes can irritate the joint capsule and surrounding tissue, generating pain signals that travel through small sensory nerves called medial branches to the spinal cord and brain.
How Does Medial Branch RFA Interrupt the Pain Pathway?
Medial branch RFA targets these specific sensory nerves rather than the joint itself. Using fluoroscopic (X-ray) guidance, a physician places a thin needle electrode near the medial branch nerve associated with the painful facet joint level. Radiofrequency energy is then delivered through the needle tip, creating a small, controlled zone of heat, a process called RF lesioning, that interrupts the nerve's ability to transmit pain signals. Because each facet joint typically receives sensory input from more than one medial branch nerve, physicians often treat multiple nerve levels to adequately address a single symptomatic joint.
What Happens Before RF Lesioning Is Performed?
Facet joint denervation is not typically the first step in evaluating suspected facet-related pain. Diagnostic medial branch blocks, temporary local anesthetic injections near the same nerves, are commonly performed first to confirm that the specific facet joint and nerve pathway are truly responsible for a patient's pain. A positive response to these diagnostic blocks, meaning meaningful temporary pain relief, is generally required before proceeding to RF lesioning, since correctly identifying the pain source is central to the procedure's likelihood of providing lasting benefit.
What Does the RF Lesioning Procedure Involve?
The procedure itself is typically performed on an outpatient basis with local anesthesia and imaging guidance. After confirming correct needle placement near the target medial branch nerve, radiofrequency energy is applied for a set duration to create the lesion. Multiple nerve levels are often treated in a single session when more than one facet joint or nerve is contributing to the pain pattern. Because the treated nerve fibers can regenerate over time, facet joint denervation is understood to provide a period of relief rather than a permanent solution, and some patients undergo repeat treatment in the future if symptoms return.
An INVAMED System Used in RF Lesioning
INVAMED manufactures the Peta Radiofrequency Ablation (RFA) System, used in nerve ablation procedures for conditions including facet-related back and neck pain. A qualified physician determines candidacy for facet joint denervation based on clinical evaluation, imaging findings, and response to diagnostic medial branch blocks, and selects the specific equipment and technique suited to the patient's anatomy. Availability and indications vary by country, and clinicians should refer to the official Instructions for Use for complete information.
How soon can someone return to normal activity after RF lesioning?
Many patients resume typical daily activities within a day or two, though some soreness at the needle insertion sites is commonly reported for several days afterward. A physician provides specific activity guidance based on the number of levels treated and the individual's overall health.
Device availability and regulatory status vary by country. Please contact INVAMED or your authorized local distributor for current regulatory information applicable to your region.