LAUSR

Instrumented lumbar spinal fusion is common and results in biomechanical changes at adjacent spinal segments that increase facet load bearing. This can cause facet-mediated pain at levels adjacent to the surgical construct. Medial branch nerve radiofrequency ablation (RFA) exists as a treatment in some cases. It is important to acknowledge that the approach and instrumentation utilized during some specific lumbar fusion approaches will disrupt the medial branch nerve(s). Thus, the proceduralist must consider the fusion approach when determining which medial branch nerve(s) are necessary to anesthetize for diagnosis and then potentially target by RFA. This article discusses the relevant technical considerations when preparing for RFA to denervate lumbosacral facet joints adjacent to fusion constructs.