Radiofrequency rhizotomy, also known as neurotomy, is a minimally-invasive procedure for treating nerve pain in the spine. The procedure works by sending pulses of heat energy generated by radio waves to the affected nerves. The goal is to stop these nerves from processing pain signals from injured facet joints, the small joints located between the vertebrae.
Normally this method of pain management is not used unless the patient’s nerve pain has not responded to other more conservative treatments, such as anti-inflammatory medication or physical therapy. The goal of a radiofrequency rhizotomy is to reduce back pain without reducing nerve function. Diagnostic testing is usually performed before the procedure to make sure precisely which nerves are causing the problem.
What is the Radiofrequency Rhizotomy Procedure?
During a radiofrequency rhizotomy, the patient lies face down. The procedure is outpatient, performed either under general anesthesia or under local anesthesia with intravenous sedation. It takes approximately one hour. After numbing the site, the surgeon uses a small needle to penetrate the skin covering the spine. The highly focused heat targets the affected nerve(s), preventing pain signals from being transmitted to the brain.
Fluoroscopy, an imaging technique, is used during the process to ensure that the small needle is inserted accurately into the appropriate facet. Depending on the patient’s condition, the needle may be inserted into more than one place on the spine.
How Painful Is Radiofrequency Rhizotomy?
Dr. Chenthitta takes great care to make his patients comfortable during their procedures. They've been in pain for far too long and should not endure more just to get to the other side of their condition. Radiofrequency rhizotomy is carefully performed to achieve the best result with minimal disruption to the patient's peace of mind. Before beginning, the doctor cleanses the skin in the treatment area, then administers a local anesthetic medication that numbs the skin and deeper tissue. Introducer needles are guided by x-ray or fluoroscopy to the area where the nerve is signaling pain, then an electrically active probe is inserted into each of the needles. This allows the doctor to test the location of the nerve to ensure accurate ablation using radiofrequency. When mild electrical stimulation takes place, the patient may feel a thumping, tingling, or buzzing sensation. This is not painful. Once the location of the nerve is confirmed, a local anesthetic is administered around the needle tip, making radiofrequency ablation a virtually painless process.
What Is The Success Rate Of A Radiofrequency Rhizotomy?
This radiofrequency procedure may not achieve pain relief for every patient. We take great care to select the best treatment option for each of our patients based on their clinical presentation of pain and diagnostic imaging data. While radiofrequency rhizotomy may not be successful 100% of the time, multiple studies rate the success of this procedure between 60% and 90%. Studies in the use of radiofrequency rhizotomy for low back pain suggest a success rate of 70 to 80%.
How Long Do The Results Of Rhizotomy Last?
Patients may achieve complete pain relief for anywhere from one year to five or more years. At some point, the nerve may regenerate itself and once again send pain signals to the brain.
Who Is A Candidate For Radiofrequency Rhizotomy?
If you are suffering from chronic neck or back pain caused by facet joint problems, whether due to injury or arthritis, you may be a good candidate for radiofrequency rhizotomy. This procedure interrupts the nerve signals from the facet joints so you can feel comfortable again. To help confirm that a patient may respond to the ablation procedure, the doctor may first administer trial injections of an approved anesthetic around the affected nerve. Studies suggest that patients who respond well to the diagnostic injections tend to also achieve good results from radiofrequency rhizotomy.
Is Anesthesia Used In Radiofrequency Rhizotomy?
The radiofrequency rhizotomy procedure is most often performed using a local anesthetic to numb the skin, then to numb the tissue around the affected nerve. Patients may also receive conscious sedation. General anesthesia is rarely used for this outpatient procedure because it may be necessary for the patient to be awake and communicative during their treatment.
What happens after the Radiofrequency Rhizotomy Procedure?
Patients should be able to resume normal activities the day after the procedure, although they may expect some soreness, numbness, itchiness or weakness in the targeted region for a few weeks. After about 3 weeks, they should be pain-free. As with most pain management treatments, radiofrequency rhizotomy does not work equally well for all patients. While symptom relief from the neurotomy is always temporary, it may provide comfort for several months or for more than a year.
What are the risks of a Radiofrequency Rhizotomy?
While the procedure is generally considered a safe one, because nerves are affected there is some element of risk. Although extremely rare, serious complications are possible, including long-term numbness, bladder or bowel incontinence, and even paralysis.