Percutaneous Lumbar Facet Rhizolysis with Radiofrequency

Chronic low back pain (CLBP) is highly prevalent and may be caused by arthritic changes in the lumbar facet joints. Percutaneous lumbar facet rhizolysis with radiofrequency (RF) has emerged as a minimally invasive procedure for the management of CLBP originating from the lumbar facet joints by selectively disrupting the medial and lateral branches of the dorsal branch of the sinuvertebral nerves transmitting pain signals from the facet joints to the nervous system. The authors employ a modern RF probe inserted percutaneously near the affected facet joint during the fluoroscopically guided procedure. Once the cannula is positioned correctly, RF energy is delivered, generating localized heat and creating a thermal lesion on the medial branch nerves supplying the facet joint. This selective thermal lesioning disrupts the pain transmission pathway without affecting motor function, thus providing pain relief for an extended period. The RF technology employed by the authors is based on Elliquence low-frequency technology and is known to cause little tissue damage beyond the target area. The authors present the clinical results with their extended clinical cohort. This procedure can be performed outpatient, requiring minimal sedation and quicker recovery than traditional surgical approaches. This chapter aims to illustrate the efficacy of percutaneous lumbar facet rhizolysis with the Elliquence RF Dart probe in the management of CLBP by comparatively analyzing the existing clinical evidence regarding long-lasting pain reduction, improved function, and overall patient satisfaction.