Last Updated: September 30, 2018
Rethi first developed the technique of radiofrequency lesioning in 1913, but it was not until 1975 when Sweet pioneered the method of thermocoagulating the trigeminal nerve rootlets for pain relief.
This technique requires the patient to be awake and cooperative because active feedback is required to map the nerve root and lesion the desired division. Refinements in surgical instruments, including finer cordotomy electrodes and real-time temperature monitors and thermocouples, have improved the safety, selectivity, and efficacy of this procedure. Introduction of a curved-tipped electrode has also further facilitated selective lesioning.
For indications, limitations, and outcomes of different percutaneous procedures, please refer to the chapter on General Considerations and Indications.