Rhizotomy Radio Frequency Ablations

What is a Rhizotomy?

A Rhizotomy is a procedure that disrupts nerve conduction by deactivating the sensory nerve to a facet joint. This prevents the pain signals from getting to the brain. The result is relief of pain on a semi-permanent basis. The nerves are usually blocked for 6-9 months (can be as short as 3 months or as long as 18 months)

How does Rhizotomy work?

A Rhizotomy uses a specialized machine to interrupt nerve conductions by using a needle that is heated. This deactivates the nerve. This is usually done twice so regeneration of the nerve is slowed. All of which is done under fluoroscopy (live X-ray).

How long does the Rhizotomy injection take?

The actual procedure can take anywhere from 30 minutes to 90 minutes depending on the amount of levels to be done.

What medications are used for the Rhizotomy injections?

At different intervals a local anesthetic (lidocaine) and steroid (kenalog) may be used.

Does the Rhizotomy injection hurt?

The procedure involves inserting needles through the skin and deep tissues just like the Medial Branch Block procedure that you probably had prior to this procedure. This procedure uses needles just a little bit larger because of the probes to check for stimulation and muscle contraction. Of course your back will be numb from the local anesthetic and you will be able to have medication for sedation including pain medication if needed.

Will I be “put to sleep” for this procedure?

No. This procedure is done under local anesthesia. Most of the patients also receive intravenous sedation and pain medication, which makes the procedure easier to tolerate. The amount of sedation given usually depends upon the patient tolerance.

How is the Rhizotomy injection done?

It is done with the patient lying on their stomach, under fluoroscopy (live x-ray). All of our patients are monitored with EKG, blood pressure cuff and blood oxygen-monitoring device (pulse oximeter). The skin on your back is cleaned with antiseptic solution and then the injection is done.

What should I expect after the injection?

Shortly after the injection, you may feel that your pain is gone or much less. You may have muscle soreness for up to a week after. Treat with ice packs and anti-inflammatories. After the first week your pain may be gone or much less.

What should I do after the procedure?

You need to have a ride home if you have had any sedation. Make sure that you have something to eat or drink after the block. We advise the patients to take it easy for a day or so after the procedure. You may want to apply ice to the affected area and take anti-inflammatory or other prescription medications you doctor advises.

When can I go back to work?

Unless there are complications, you should be able to go back to work the next day. The most common thing you may feel is a sore back or neck depending on the injection site. Ice, ibuprofen or acetaminophen or medications prescribed by your doctor will help with any discomfort.

How long will this procedure help me?

If successful, the effects of this procedure should last from 3 to 18 months, usually 6-9 months.

Can I have this procedure again in the future if necessary?

If the first procedure does not relieve your symptoms completely, you may be recommended to have a repeat procedure after re-evaluation, possibly at another level. Because a Rhizotomy is not a permanent procedure, it may need to be repeated when the nerves to those areas regenerate possibly (6-12 months).

Will the Rhizotomy help everyone?

Usually, the patients who have had a good response to the Medial Branch Block procedure prior to rhizotomy have better results.

What are the risks and side effects?

The procedure is safe. But with any procedure there are risks, side effects, and the possibility of complications. The most common side effect is pain-which is temporary. The other risk is infection, this is why we maintain sterile conditions. The nerves to be lesioned may be near blood vessels or other nerves, which can be potentially damaged. Great care is taken by checking stimulation of nerve and muscle at the site along with fluoroscopy.

Who should not have this procedure?

If you have not responded to local anesthetic blocks (i.e. Medial Branch Blocks or Facets) you may not be a candidate for this procedure. If you are allergic to any of the medications to be injected, if you are on a blood thinning medication (i.e. Coumadin, Plavix) aspirin or aspirin containing medications, or if you have an active infection you should not have the injection. Be aware that herbs Ginseng, Garlic and Gingko Baloba and Vitamin E are blood thinning.

*DO NOT STOP ANY OF YOUR MEDICATIONS BEFORE CONSULTING WITH YOUR DOCTOR*