Radiofrequency Rhizotomy

Radiofrequency Rhizotomy

Diagnosis:  ___________________

The patient presents today for radio frequency rhizotomy of the medial branch nerves of the cervical facet joints at the C4-C5, C5-C6, and C6-C7 levels on the right/left side.

Procedure:  The patient/family member has been informed of the risks and benefits of the planned procedure.  Procedure – radiofrequency rhizotomy of the medial branch nerves of the cervical facet joints at the C4-C5, C5-C6, and C6-C7  levels on the  right/left side

Informed consent was obtained.  In the fluoroscopy room, the patient was placed in a prone position and pillows are placed under the chest to allow the cervical spine to be moderately flexed without discomfort.  The patient’s forehead was allowed to rest on a folded blanket on a small pillow.  An AP view of the cervical spine was obtained.  The fluoroscopy beam was rotated to view the center of the neural arch.  The target level was then identified.  The skin was prepped and draped in a sterile manner.  Under fluoroscopic the skin and deeper tissues were numbed with 0.5% lidocaine.  Under fluoroscopic guidance a 2-inch, 20 gauge radiofrequency probe was guided to contact the centroid of the neural arch.  The needle position was confirmed on AP and lateral views.  Initially sensory stimulation was done, and then motor stimulation was done.  Contractions of the multifida were noted.  No extremity contractions noted.  The impedance at each of the levels was noted to be  right/left at the C4-C5 level,  right/left at the C5-C6 level,  right/left at the C6-C7 level.  Then using the radiofrequency rhizotomy technique, the medial branch nerves at each of these levels was lesioned.  The duration of the lesioning was 120 seconds and the temperature was maintained at 42 degrees.  The patient tolerated the procedure well.  Complications none.