Facet Denervation (Cervical / Lumbar Spine) in Munich: Minimally Invasive Spinal Pain Therapy

Medical Basics

What is facet denervation?

The small vertebral joints (facet joints) connect the vertebral bodies and enable controlled spinal movements. Due to wear or chronic overload, these joints may become painfully irritated or develop arthritic changes.

Facet denervation - also known as radiofrequency denervation - specifically interrupts the pain-conducting nerve fibers at the affected facet joints. This is done thermally, without surgically damaging the joint structure or surrounding tissue.

Which structures are affected?

• Facet joints of the cervical spine (C-spine)
• Facet joints of the lumbar spine (L-spine)
• Pain-conducting nerve fibers (medial branches)

Causes and Risk Factors

Facet-related pain often arises from:

• Degenerative changes of the spine (facet joint osteoarthritis)
• Chronic misload or overload in everyday life or work
• Lack of physical activity and muscular imbalances
• Previous spinal injuries
• Aging processes of the spine

Typical Symptoms

The symptoms are usually localized and differ from radiating nerve pain:

• Chronic neck or back pain
• Pain aggravated by certain movements or postures
• Morning stiffness or load-related pain
• Muscle tension in the surrounding area

Distinction

In cases of herniated discs with pronounced nerve root irritation, paralysis, or sensory deficits, facet denervation is generally not indicated and other treatment options are required.

Diagnostics

Before a facet denervation, structured diagnostics are carried out at the Gromer Orthopedic Clinic in Munich:

• Medical history: pain location, duration, progression
• Clinical examination with functional and movement tests
• Imaging (e.g. MRI or CT)
• Diagnostic infiltration (local anesthetic block) to confirm the pain source

Only if the test injection produces a positive response, denervation is considered.

Treatment Options

Conservative Therapy

Before interventional treatment, conservative measures are usually exhausted, including:

• Physiotherapy and stabilization training
• Medication-based pain therapy (temporary)
• Facet joint infiltrations
• Manual therapy

Facet Denervation

The procedure is performed on an outpatient basis under X-ray or CT guidance. After local anesthesia - with light sedation if needed - the pain-conducting nerve fibers are precisely heated using radiofrequency to about 80-90 °C and functionally interrupted.

The procedure typically takes about 15-20 minutes. Often, a small amount of hyaluronic acid is injected afterward to support joint mobility and reduce local irritation.

Progress and Prognosis

Studies show that approximately 60-80 % of patients with confirmed facet pain achieve significant to complete pain relief. The effect usually lasts 12-24 months, sometimes longer. If symptoms return, the procedure can be repeated.

Aftercare

• 1-2 days of physical rest
• Gradual resumption of normal movement
• Targeted physiotherapy to stabilize the spine
• Evaluation of treatment success through pain and function tests

Conclusion

Facet denervation is a scientifically proven, minimally invasive method for treating chronic, localized spinal pain. At the Gromer Orthopedic Clinic in Munich, it is used as an effective option between conservative therapy and surgical intervention after precise diagnostics.