Rhizotomy is a minimally invasive treatment that is performed to reduce or relieve facet joint pain.  A rhizotomy disrupts a nerve’s ability to transmit pain signals to the brain. You have facet joints in your cervical (neck), thoracic (mid back), and lumbar (low back) spine.  The facet joints are part of the spine’s motion segments.

Rhizotomy targets a facet joint’s medial nerves.  Basically, the procedure involves applying an electric field to the target nerve to generate heat sufficient to disrupt the nerve’s ability to transmit pain signals.  Rhizotomy may provide pain relief for up to a year, sometimes longer.

Other terms for rhizotomy…

  • Radiofrequency (RF) rhizotomy
  • Pulsed RF rhizotomy
  • RF therapy
  • RF ablation

Some causes of facet joint pain …

Preparation for rhizotomy

Your doctor reviews all the medications, vitamins and herbal supplements you take.  Certain drugs (e.g., blood thinners), such as NSAIDs (non-steroidal anti-inflammatory drugs) and supplements should be stopped several days before your procedure.  If you are taking an anti-inflammatory medication, your doctor may ask you to stop taking the NSAID, so he can accurately assess the effectiveness of rhizotomy and reduce the risk of bleeding.

Possible risks of rhizotomy

All medical procedures are inherent for risk.  Rare but serious complications include bleeding, infection, headache, nerve injury, and allergic reaction to medications used during treatment.  Your doctor thoroughly discusses your personal risks with you before the procedure.

The Rhizotomy Procedure

A rhizotomy is performed in a sterile setting, such as an operating room or ambulatory surgery center suite.  You change into a gown.  An intravenous line is started, and medication is administered through the IV to keep you comfortable.  You may be awake or in a twilight state.

In the surgical suite, you are positioned to give the doctor access to the spine.  The skin area is cleansed using a sterile soap.  A local anesthetic is injected to numb the area.  A special imaging machine called a C-arm (fluoroscopy) is positioned to enable your doctor to view the spinal level during the procedure.  A small amount of contrast (dye) is injected to confirm needle/electrode placement.  Next, controlled, mild electrical current is fed to the electrode disabling the nerve’s ability to transmit pain signals.

After the rhizotomy procedure

The procedure takes about 15- to 20-minutes but may take longer if more than one spinal level is treated.  A small bandage covers the entry point of the needle/electrode.  You are moved into a recovery area and closely monitored before being discharged home with written aftercare instructions.  We call you the day after your procedure to follow up.

Keep a pain diary

You may experience some discomfort for a few days after the procedure.  This is normal.  We ask you to record your pain levels and other symptoms after the procedure.  Your pain diary helps your doctor fine-tune your treatment plan.

Learn more about rhizotomy from these online sources:

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