Radiofrequency Rhizotomy

What is it?

Radiofrequency (RF) rhizotomy, or RF neurotomy, is a therapeutic procedure designed to decrease or eliminate pain symptoms from spinal joints.

How is it done?

The procedure involves using a needle to carefully place a small electrode adjacent to the facet under x-ray guidance. An electric current is then used to cauterize the sensory nerves that innervated the facet joint(s). If successful, the pain relief following an RF procedure can last considerably longer than the relief that follows local anesthetic and steroid blocks. The RF rhizotomy process can be used on any area of the spine – cervical, thoracic, or lumbar.Before a patient can be scheduled for an RF rhizotomy procedure, he/she must undergo a series of facet injections and/or discography tests to verify the exact source of his/her symptoms. These tests may require several visits. If these exams have been performed elsewhere within 90 days, the physician will need to review these results. Because of the potential irreversibility of the rhizotomy, it is important to verify the exact nerve or nerves from which the symptoms originate. For this reason, some of these pre-procedure exams may need to be repeated by the physician, who will later perform the RF procedure.Due to the trauma to the nerve, the patient may experience an increase in symptoms for 5-7 days after the procedure. Pain relief benefits from the rhizotomy should be apparent within 2-4 weeks.

Expected results:

Following the neurotomy, there is a 60% chance of pain relief. This typically will last for 3 months to 1½ years. The nerve eventually grows back and the procedure can be repeated. While the patient is experiencing pain relief, vigorous physical therapy is necessary to try and strengthen the involved facet(s).

How long does it take?

The neurotomy takes 10 to 45 minutes, depending on the number of levels to be done. The patient the recovers in the observation area for 30-60 minutes.

Risks involved:

Increased localized back pain can be expected from several days to several weeks. Weakening of the musculature surrounding the facet joint may occur. Post-injection training to strengthen the extensor muscles may help with overall recovery.

Side effects:

Increased localized back pain and/or leg pain can be expected from several days to several weeks and up to several months. Destabilization of the facet joint is a risk and post-injection training to strengthen the extensor muscles can prevent this possibility.

 

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