Selective facet denervation/facet joint denervation

Facet syndrome

Back pain can have many causes. With people aged over 50 the reason for this is often facet syndrome. In this damage to the joints caused by wear and tear (arthrosis) in the so-called facet joints leads to chronic pain. These joints arranged in pairs lie between the lateral sections of the vertebral arches. With facet syndrome it is the facet joints of the lower lumbar spine that are most commonly affected.

Diagnosis

In order to diagnose facet syndrome, if there has been persistent back pain for a longer period, the doctor initially uses imaging procedures (X-ray, MRI) to assess the condition of the vertebral column section.

If facet syndrome is suspected, using imaging guidance he injects a local anaesthetic directly into the selected facet joint. If this clearly alleviates the pain, the diagnosis and location are confirmed.

Treatment options

In the first stage of treatment the patient receives pain-relieving non-steroidal anti-inflammatories (NSAID), often in combination with physiotherapy.

If this treatment does not lead to more longer-lasting success, there is the option of facet joint denervation. In this the chronic pains are reduced long-term. In a virtually painless, minimally invasive procedure, which can be performed on an outpatient basis, the doctor interrupts the conduction of pain in the nerve branch of the affected facet joint. This is carried out via the targeted impact of heat (thermolesion). With the use of imaging guidance, the sfm radiofrequency/thermolesion needle achieves safe and almost pain-free access to the stimulus transmitting nerve of the identified facet joint. Once the needle is placed in the target area, coagulation of the nerve fibres is achieved using a thermal probe and high frequency current (radiofrequency), which prevents stimulus transmission.

The pain-relieving effect can last for several months up to two years [1]. Because new nerve branches can form, it is possible that the pains will increase again. In this case a repeat of the facet joint denervation is usually possible without problems.

Benefits of facet joint denervation using the sfm radiofrequency/thermolesion needle

  • Minimally invasive treatment, can be performed on an outpatient basis under local anaesthesia
  • Low penetration force thanks to optimum bevel geometry and a smooth transition to the coated needle region
  • Minimisation of pain sensation and posttraumatic stress due to the smooth transition to the needle coating
  • Best possible navigation to targeted coagulation thanks to the hub design and its realization
  • Optimum adjustment of the coagulation field thanks to the large number of design variations
  • Long-term reduction of pain
  • Reduction of the analgesic requirement
  • Treatment can be repeated as required

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