FACET JOINT RADIOFREQUENCY OR RHIZOTOMY

Question:

Dear Dr. Veliz:

I’ve read about a procedure which involves burning nerves in the spine in order to decrease pain. I’m confused. If you burn a nerve, won’t this leave you paralyzed?

Answer:

Radiofrequency ablation or lesioning is also termed rhizotomy. In the case of facet joints, radio waves are used to produce heat in order to destroy a nerve. A needle is placed into the facet joint under x-ray guidance and radiofrequency waves are transmitted through the needle. The reason that paralysis should not occur is that the nerves being targeted are called sensory nerves and not motor nerves. They are called medial branch nerves and they carry pain signals from the facets joints to the spinal cord. In summary, heat is being used to destroy a sensory nerve, not a motor nerve. You are correct in your assumption that destroying a motor nerve can lead to weakness or paralysis. Your pain management specialist can minimize the risk of destroying a motor nerve by using x-ray guidance, understanding spinal anatomy and performing a test prior to the actual destroying of the nerve.

I hope this clarifies the issue for you.