Radiofrequency ablation (RFA), also known as Rhizotomy, is commonly used to treat chronic neck or back pain. The word “Rhizotomy” can be broken down into “rhizo” and “tomy,” meaning “root” and “dividing,” respectively. The root words are significant as they express the procedure of disabling the root of the nerve to reduce the ability to send pain signals. Dr. Giuffrida goes into more detail in the video below:
Types of Rhizotomies
Rhizotomies have different types of procedures to achieve the goal of reducing pain signaling. Glycerol, radiofrequency, and endoscopic are all types of rhizotomies that can interrupt nerve fiber transmission.
- Glycerol rhizotomy utilizes the chemical to destroy the targeted nerve(s) of the affected areas.
- Radiofrequency rhizotomy, radiofrequency ablation, utilizes a radiofrequency current to burn the nerve fibers of the affected area. This is the most common method used by interventional pain specialists.
- Endoscopic Rhizotomy uses a microscopic camera to guide the physician to the affected nerve which will then get surgically ablated, disconnecting the fibers from the root.
In general, rhizotomies are non-surgical, minimally invasive, and deemed very safe and effective. The benefits include pain relief, function improvement and decreased need for pain medication.
Before the Procedure
As stated above, Radiofrequency Ablation is the most commonly used method. The procedure process first requires two diagnostic facet nerve blocks to be performed.
The optimal pain generators are determined by these tests and subsequent follow ups with your physician. If the tests result in a relief from pain, then an RFA procedure can be scheduled and performed.
How the Procedure Works
Radiofrequency rhizotomy is a very common procedure. The performing physician will have reviewed your MRI and the success of the diagnostic nerve blocks, which will give him/her the optimal area to treat.
To start the procedure, the patient may be moderately sedated. Once sedated, the physician will insert a thin needle, guided by x-ray imaging, in the optimal area to be burned. Once the needle is in the desired area, local anesthesia will be injected to numb the area. After numbing, a probe will be inserted into the needle, which will deliver the radiofrequency waves to the nerve.
If desired, multiple nerves can be burned during the procedure. A typical rhizotomy procedure lasts less than 15 minutes. After the nerves are ablated, the patient will be moved back to their recovery room and will be able to go home shortly after.
After the Procedure
Recovery from an RFA tends to be very easy and fast. Someone must drive you home, but the typical recovery lasts from 24-48 hours until you can return to normal activities.
Patients tend to feel immediate relief after the procedure. However, they will not feel the full effects until about three weeks post-procedure. The relief from a rhizotomy tends to last anywhere from 6 months up to 2 years, depending on how quickly the nerves heal. RFA can be repeated up to twice a year to give continuous relief.
Risks and Side-Effects
There can be a slightly painful sensation in the burned area, called neuritis. The sensation, only lasting a few days, is most often described as similar to a sunburn.
Other risks can range from minimal to severe as this procedure infiltrates the body. However, Rhizotomy and RFA tend to be very safe procedures.
What Conditions can RFA Treat?
Rhizotomy is a very beneficial procedure that can treat a range of conditions.
Some of the conditions are:
- Arthritis
- Herniated disc
- Degenerative spinal conditions
- Facet arthropathy
Who Performs a Rhizotomy?
At Cantor Spine Center, our highly trained Interventional pain management team utilizes radiofrequency ablation to its fullest potential.
We work through the process efficiently and correctly, ensuring the optimal area is determined to give our patients the most excellent satisfaction.
If you are interested in scheduling a consultation to see if you would be suitable for a rhizotomy, click here!