A radiofrequency neurotomy is a type of injection procedure in which a heat lesion is created on certain nerves with the goal of interrupting the pain signals to the brain, thus eliminating the facet or sacroiliac joint pain. A medial branch neurotomy affects the nerves carrying pain from the facet joints, and a lateral branch neurotomy affects nerves that carry pain from the sacroiliac joints. These medial or lateral branch nerves do not control any muscles or sensation in the arms or legs so there is no danger of negatively affecting those areas. The medial branch nerves do control small muscles in the neck and mid or low back, but loss of these nerves has not proved harmful.
Before this procedure is undertaken, the joints and branch nerves will have already been proven to be painful by a diagnostic form of spinal injection, and will not have responded to other treatment methods. If effective, the neurotomy should provide facet or sacroiliac joint pain relief lasting at least nine to fourteen months, and sometimes much longer. After this period of time, however, the nerve will regenerate, and the facet or sacroiliac joint pain may return.
Success rates vary, but typically about 30% to 50% of patients undergoing this procedure will experience significant facet or sacroiliac joint pain relief for as much as two years. Of the remaining patients, about 50% will get some pain relief for a shorter period. Some patients do not experience any relief from facet or sacroiliac joint pain as a result of this procedure.