An endoscopic radiofrequency is a minimally invasive procedure in which the nerves that innervate the facet joints are removed through a small tube using small instruments. The procedure is an out patient procedure usually performed under light sedation. The procedure offers another means of pain relief for facet joint related pain. Typically this procedure is performed on patients with severe pain related to the facet joints. This procedure is an alternative to percutaneous (needle) radiofrequency ablation, where either the patient has disease that may appear to not be amenable to the percutaneous (needle) approach, such as patients with severe facet joint disease, history of lumbar fusion, or severe scoliotic curvature, and have had a positive response to the diagnostic component of a lumbar medial branch block. The endoscopic radiofrequency is also an options for patients that have recurrent pain after 6-9 months of relief with the percutaneous radiofrequency ablation and do not wish to repeat the percutaneous approach.
The procedure is performed in an outpatient surgical setting under light anesthesia. Special equipment is used including a fluoroscope (live time x-ray machine) and a monitor to view into the spine through the scope, and small instruments are used to ablate the nerves.
A small incision is made over the facet joint (usually ~2 cm from the center of the spine) and after local anesthetic is administered, the port, which is the size of a small pen chamber, is passed onto the facet joint. Then a camera is inserted into the port along with instruments to transect and then ablate the medial branch nerves. Under direct visualization the nerve is localized and ablated. Once the nerve is ablated, the facet joint ineffectively transmits pain to the brain. When adequate nerve ablation has occurred, the tools are removed, a suture is placed under the skin and a bandage is placed.
To Learn More
If you are interested in an evaluation into the cause of your low back pain, or want to be evaluated for an endoscopic radiofrequency procedure to help you manage your pain, please contact our pain management experts at The Spine and Pain Institute of New York. Our offices in Manhattan, Staten Island, Brooklyn and Long Island offer multiple convenient locations for you to be evaluated. We would be happy to make an appointment for a consultation and provide additional information about other treatment options.