Scott and I Are Falling Apart

Michelle is taking Scott to Chemo on Friday. So I can have my facets cauterized. So we will see how are weekend goes.

Neurotomy

Anatomy

Facet joints are pairs of small joints that separate the vertebra on the back side of the spine in the lumbar (low back), thoracic (mid-back), and cervical (neck) regions. These joints can become inflamed and painful from either injuries or arthritic conditions. When facet injections of local anesthetic and/or cortisone provide temporary pain relief, you may be a candidate for a facet neurotomy which can provide pain relief lasting up to six months or longer.

A facet neurotomy involves destroying the nerves that relay pain messages from the facet joints. This is accomplished by using a technology called Radio Frequency Thermal Coagulation (RFTC). Under x-ray guidance, your physician places a fine probe, not much larger than the needle used in facet injections, down to the nerves that supply the facet joint(s). A controlled heat lesion is then made using RTFC. Each facet joint has at least two nerve branches therefore several lesions may need to be done at the time of the procedure.

What will happen during the procedure?

An IV will be started so that relaxation medication can be given. You will be taken to a procedure room and positioned lying on your stomach. Monitors will be placed on you to watch your heart rate, blood pressure, and blood oxygen level.

After your skin is washed with a sterile scrub, the facet joints will be identified by your physician using a fluoroscopy (x-ray) machine. Small marks may be placed on your skin using a sterile pen. The skin is numbed with local anesthetic medication. Using fluoroscopy guidance, your physician inserts the radiofrequency probes near the facet nerves. A series of steps involving stimulating the nerves with electricity helps localize the facet nerves. Local anesthetic is then placed through the probes to numb up each nerve. The tips of the probes are then heated thus cauterizing each facet nerve.

What will happen after the procedure?

You will then be taken back to the recovery area and monitored for 30-60 minutes. Discharge instructions will be given to you before leaving the surgical center.

Due to the use of relaxation medication, you are required to have a driver to take you home.

Expectations

You should expect to have a few days of moderate post-procedure pain. It may take up to three to four weeks before you are able to determine the procedure's effectiveness. Some individuals will experience burning sensations at the skin which resolve in a few days time.