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Radiofrequency Neurotomy of the Thoracic Facets

What is Radiofrequency Ablation (RFA) of the Thoracic Facets? 

Radiofrequency ablation (RFA), also known as a Radiofrequency Neurotomy, of the thoracic facets is a minimally invasive procedure used to treat chronic upper back pain caused by dysfunction or inflammation of the facet joints in the thoracic spine. By precisely heating and disrupting the transmission of pain signals from the affected nerves, a RFA can provide long-lasting relief for patients whose upper back pain has not responded adequately to conservative treatments. 

How is Radiofrequency Ablation (RFA) of the Thoracic Facets Performed? 

To perform radiofrequency ablation of the thoracic facets: 

  1. 1. The patient lies face-down, and the treatment area in the upper back is thoroughly numbed with a local anesthetic to minimize discomfort. 
  2. 2. Under fluoroscopic (X-ray) guidance, the physician carefully inserts a thin needle through the skin and directs it towards the medial branch nerves, which carry pain signals from the thoracic facet joints. 
  3. 3. An electrode is then advanced through the needle and positioned next to the target nerves. 
  4. 4. The electrode is then activated, delivering radiofrequency energy that creates a controlled thermal lesion on the nerves, disrupting their ability to transmit pain signals to the brain. 
  5. 5. This process may be repeated to ablate multiple painful nerve branches, as needed, to provide comprehensive pain relief. 

What Supplies and Medications are Used for Radiofrequency Ablation (RFA) of the Thoracic Facets? 

The key components for this procedure include: 

  • – Local anesthetic (e.g. lidocaine) to numb the treatment area 
  • – Fluoroscopic imaging equipment to precisely guide needle and electrode placement 
  • – Radiofrequency generator and specialized electrode to deliver the thermal ablation 

The physician selects the appropriate equipment and techniques based on the patient’s anatomy and the specific nerves being targeted. 

What to Expect After Radiofrequency Ablation (RFA) of the Thoracic Facets? 

After the procedure, the patient may experience some discomfort or soreness at the treatment site, which can typically be managed with over-the-counter pain medication. Over the next several weeks, patients often report a gradual reduction in their upper back pain as the ablated nerves regenerate and the full effects of the procedure take hold. 

The pain relief provided by RFA of the thoracic facets can last for several months, though the duration may vary depending on the individual. Patients should follow their physician’s instructions regarding any activity restrictions and schedule any necessary follow-up appointments. They should promptly report any concerning symptoms, such as increased pain or new neurological deficits, to their healthcare provider. 

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