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Radio Frequency Ablation for Cervical Facet Disease
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Radio Frequency Ablation for Cervical Facet Disease

Dr. Rosen,

I've been suffering from chronic unrelenting cervicogenic "A-typical Tension Headaches." for several years. Symptoms are pressure, tightness and hangover-like Neuro & cognitive symptoms. Feels like I'm wearing a helmet that's too tight. Was diagnosed by a Neurologist with Cervical Facet Disease/cervicogenic headaches. He tried PT, chiron & a myriad of meds to no avail. Botox was suggested but is expensive, transient in relief, and not covered by insurer.

I had 3 lidocaine facet blocks under fluoroscopy at an academic hospital with no improvement. The 4th was helpful albeit, with transient results. Consquently, a Radio frequency ablation procedure was performed on the aforementioned 4th facet. It's been a couple of weeks & I've had no improvement. MD wants to do more blocks on the other side of my cervical facet joints.

At this point, I'm confused & not sure which direction to turn. The Radio Frequency Ablation was painful and it appears the results are hit or miss. I'm puzzled why the block worked, yet the ablation didn't. Can sysmptoms come from more than one Facet Joint nerve, thus ablating them all is an option? Do you have any other more benign treatment suggestions?

Thanks for your help, most appreciated.
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Dear Kim,

Yes the symptoms can come from more than one facet, and they can be coming from the disc too.  In that case, facet injections won’t help.  You need a diagnosis that correlates your symptoms with imaging studies.  

Dr. Rosen

Charles Rosen, MD
Clinical Professor of Orthopaedic Surgery
Spine Surgery
University of California, Irvine, College of Medicine
Founding Director, UCI Spine Center  
Orange, California

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