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  Epidural Injections
Facet Joint Injections
Nerve Blocks
Discography
Radiofrequency Lesioning
Spinal Cord Stimulation
Intradiscal Electrothermal Annuloplasty
Nucleoplasty
Botulinum Toxin Injections
Acupuncture
Pharmacotherapy Management
Quantitative Sensory Testing
Trigger Point Injections
Intrathecal Implantable Pumps
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Radiofrequency Lesioning (RFL)
Heat coagulation was introduced in 1974 as a way to treat pain from facet joint disease. Radiofrequency lesioning requires the placement of probes through the skin with the use of x-ray technology called fluoroscopy. Stimulation of sensory and motor nerves is then done to assure proper placement of the needle. Once the proper placement is certain, the probe is heated for 60 to 90 seconds. This process has since been used to destroy parts of the trigeminal ganglion, dorsal root entry zone, and to destroy parts of the spinal cord. It has been used in the treatment of peripheral nerve lesions, neuromas (benign nerve tumors), and coccydynia (pain in the coccyx). Currently, the major use of RFL is in the treatment of facet disease. Radiofrequency lesioning is performed only after pain relief is obtained with a diagnostic block. RFL is performed if prolonged relief is not seen with these blocks. A RFL lesion may not provide a permanent cure as the nerve fiber will usually regenerate . The length of time pain is relieved by RFL is quite variable. The procedure may have to be repeated in order to provide optimal pain relief.
Indications: Facet Joint related Back and Neck Pain, Neuralgias, certain headaches
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