Facet joints exist throughout the spine and are formed by the articulation of the vertebrae in the spinal column. Each of these joints is enervated by the medial branch of the dorsal nerve. During an automobile accident, these joints can be subjected to tremendous force or stress resulting in an extremely painful and permanent injury. The injury to the facet joint can present as unrelenting headaches or severe neck or back pain. Traditional treatment for "soft tissue" muscle and ligament sprain/strains, such as physical therapy, chiropractic adjustments, massage therapy, oral anti-inflammatory medication, and steroid injections, are ineffective in dealing with the pain caused by a facet joint injury. Fortunately, recent medical improvements now permit the diagnosis and treatment of facet joint injuries.
Facet joint injuries are diagnosed by undergoing a procedure known as a medial branch block. During the medial branch block, the doctor injects an anesthetic into the facet joint and anaesthetizes the medial branch of the dorsal nerve inside the joint. If the medial branch block relieves the patient’s pain for the known duration of the anesthetic, the doctor can conclude the source of the patient’s pain is an injury to the facet joint. A subsequent medial branch block is later administered to confirm the diagnosis.
Once the diagnosis has been confirmed, the patient undergoes a procedure known as a radio frequency neurotomy or rhizotomy.
During the neurotomy, the doctor cauterizes the end of the medial branch nerve. The cauterization of the medial branch nerve disrupts the transmission of pain from the injured joint to the brain thereby relieving the patient’s pain. The procedure is considered successful if at least 75% of the patient’s pain is eliminated by the neurotomy.
Eventually the nerve end regenerates and the patient’s pain may return. The duration of relief varies by individual, but usually lasts 12 months. The procedure can be repeated indefinitely if a patient’s pain continues to return upon regeneration of the nerve.
Many patients experience complete pain relief after undergoing a neurotomy and are able to resume all of their former activities without restriction.
• James underwent both cervical and lumbar neurotomies in 2009. His case settled for $178,000.
• Ann underwent two lumbar neurotomies with mixed results. Her case settled for policy limits of $75,000.
• Nicole underwent one cervical neurotomy and her case settled for her uninsured motorist policy limit of $50,000.
• Wanda was rear ended by an uninsured motorist. She underwent two lumbar neurotomies. After her second neurotomy, her claim for uninsured motorist benefits was settled for her policy limit of $100,000.
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