Cervical Thoracic Radiofrequency Facet Joint Denervation / The 'Dose Pulse' Concept

摘要

This presentation is in two parts; the first part is purely technical and deals with the steps involved in carrying out Cervical and Thoracic Radiofrequency Facet Joint denervations. The second part examines the new 'dose pulse' concept of delivering pulsed radiofrequency.The first part of the presentation relies heavily on illustrations produced by the medical graphic designer Basia Jankowiak, which appear in the author's textbook, 'Manual of RF techniques' (Flivo Press 2004; ISBN 3-909 441-03-3).The presentation starts by analysing the 'needle tip vs. needle shaft' question for producing conventional RF lesions and then examines the tissue destructive powers of conventional RF and the various lesion generators, which the author uses in his practice.The anatomy of the cervical facet joints with special reference to the position of the medial branches of the posterior primary rami, which supply the joints, is next discussed in some detail; this is then followed by an illustrated description as to how the medial branches can be lesioned.