This is similar to the conventional facet neurotomy; except that pulsed radiofrequency waves are delivered at a lower temperature (just three to five degrees over body temperature). It is thought that by avoiding the burning, that less damage to the nerve is done, and that there are fewer tendencies for the nerve to want to regenerate. In addition, the pulse radiofrequency creates an electro-magnetic field that may reprogram the dna in the nerve to stop pain transmission. This technique was recently fda approved.

How long does it take?
The neurotomy takes 30 to 45 minutes, depending on the number of levels to be done. The patient is then recovered in the observation area for 30 minutes to 1 hour.

Potential risk?
Increased localized back pain and/or neck pain can be expected from several days to two weeks and rarely beyond this. There is less nerve damage potential than the conventional neurotomy and thus in my opinion it is the procedure of choice. It may be in the dna or other structures of the nerve are scrambled, as opposed to the whole nerve being burned with conventional radiofrequency.

Glossary
Facet joints
Joints located on the back of the spine on each side where one vertebra slightly overlaps the adjacent vertebrae. They guide and allow the complicated movements of the spine. They are like the facets of a diamond, which is smooth and have almost no friction.
Fluoroscopy
X-ray like imaging (which uses much less radiation) of a part of the body that is displayed on a screen or monitor in the block suite - this facilitates and assures proper placement of the needle and medication. There is also an intensifier, which magnifies the image, and improves the accuracy of the treatment. Furthermore, a hard copy can be made for insurance, medical legal and purposes of comparison.
Inflammation
Tissue reaction to irritation
Sympathetic nerves
A network of nerves extending the length of the spine that control some of the involuntary functions of the body such as opening and narrowing blood vessels. They are involved in rsd or chronic regional pain syndrome.

Definitions:
Facet joint syndrome
A constellation of symptoms which result in diffuse pains that do not fit a clear nerve root pattern (e.g. not sciatica), these pains are worsened with movement of the spine, poor posture, often sleep, sometimes associated with cold burning sensations, usually worsened by cold damp weather and are now known to emanate from the tiny medial branch nerves that supply the facet joint.

Remember the only way to definitively make the diagnosis is by a diagnostic/prognostic facet block

Facet neurotomy
Is a procedure that results in interruption of the nerve supply to a facet joint.

Pain block
Is an anesthetic injection near or in a certain area that is thought to cause or generate pain.