Pulsed Radiofrequency Neurotomy for Facet Disease in the Neck

Pain and other symptoms associated with facet disease in the neck are often treated these days with a fairly new method called pulsed radiofrequency neurotomy (PRFN). This is a minimally invasive procedure that employs a targeted electrical field to disrupt nerve function, thereby reducing or eliminating pain. Unlike conventional radiofrequency therapy - which uses a sustained electrical signal to destroy nerve fibers - PRFN merely stuns the targeted nerves in order to prevent the transmission of pain signals.

How Does PRFN Work?

One way facet disease in the neck produces symptoms is through the production of osteophytes, or bone spurs. These bony protuberances are not a problem on their own, but they can produce localized pain, tingling, numbness, or muscle weakness in other parts of the body if they make contact with a spinal nerve root or the spinal cord. If it is determined that spinal nerve compression is responsible for the symptoms associated with facet disease, PRFN might be used to target the affected nerve. The pulses of radiofrequency render the nerve temporarily incapable of transmitting signals between the brain and the rest of the body. The effects can last for several months, during which the physical abnormalities in the spine and nerve compression may resolve themselves as the body adjusts.

How is PRFN Performed?

Using a fluoroscope for visual guidance, the doctor inserts a transmitter intravenously and positions it above the targeted nerve. Then, pulses of electricity are sent through the transmitter for several minutes. While there may be some post-procedural discomfort at the site where the transmitter was inserted, the procedure itself is relatively painless and an over-the-counter anti-inflammatory medicine is usually enough to manage any residual discomfort. Should the nerve-related pain return after several weeks or months, PRFN can be performed again with little or no risk of complications.