Facet joint denervation

What is it?

In order to confirm that the facet joints contribute to your pain, a test block (e.g. diagnostic block) is first performed at the level of the joints. A positive block is used as an indication, but is not an absolute guarantee that radiofrequency denervation will be successful. It is necessary to first do this, however, so that the facet denervation will be reimbursed.

Due to wear and tear (arthrosis), inflammation, an operation or an accident, there can be changes to the facet joints (mobile connections between the vertebrae). When this happens, the joints can become irritated and then cause pain in the neck, chest or lumbar area.

A ‘denervation’ of the facet joints can be useful in this case. Using a radiofrequency current, the relevant nerve branch is heated. This heat affects the nerve and blocks the pain signals that travel along the nerve pathways of the facet joints towards the brain. With the (temporary) denervation, the pain can be reduced for a longer period.

A test block and a facet denervation cannot be performed on the same day. Denervation can be performed during the first three months after a positive test treatment.

Treatment procedure

Preparation

Come to the hospital on the day of treatment.
You do not need to be fasting for the treatment. You may eat and drink.

By law, you may not drive any vehicles or operate machinery the morning after the treatment. Therefore, make sure that somebody can take you to and from the hospital. The physician or nurses can provide you with certificates, if required. If you wish, the nurses of the Pain Centre can order a taxi for you.

Always inform the physician if:

you have diabetes or a heart condition
you are (or could be) pregnant
you are allergic to certain medications, contrast agents or iodine (disinfectant), latex, etcetera
you take blood thinners

If you have reduced kidney function, have recently experienced thrombosis or a heart attack or have had a stent implanted, you must contact your attending physician first.

Medication	Stop	Comments
Asaflow®, Aspegic® Cardioaspirin®, Aspirin® Dispirl®, Sedergin®	Stop if >500 mg/day
Marcoumar®, Sintrom® Marevan®	Seven days before the procedure	Replace with injections (see Clexane, for example) Anticoagulation before the procedure
Ticlid®	ten days before the procedure
Plavix®, Clopidogrel Brilique®, Efient®	Seven days before the procedure
Xarelto®, Eliquis® Lixiana®, Pradaxa®	48 hours before the procedure
Fraxiparin®, Clexane® Fraxodi®	24 hours before the procedure	Restart 6 hours after the treatment 3 days afterwards, take together with regular blood thinners After a week, anticoagulation follow-up with your GP

Leaflet

You can find more information in the leaflet at the bottom of the page.

the test block process
course of the admission and the treatment
the possible side effects and complications

Only available in Dutch:

Ontzenuwing van de facetgewrichten

Download

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Centres and specialist areas

Pain Centre

Pain Clinic

Latest publication date: 01/02/2024
Supervising author: Dr Decaigny Veronique