Lumbar Rhizotomy: Procedure and Recovery

A rhizotomy is a surgical procedure that involves cutting or ablating the sensory nerve roots that transmit pain signals from a specific area of the body to the brain. This procedure is typically performed on patients who suffer from chronic pain, such as back pain, neck pain, or facial pain, that does not respond to other traditional forms of treatment.


What Conditions Does Endoscopic Facet Rhizotomy Treat?  

Endoscopic facet rhizotomy is typically used to treat chronic back pain that originates from the facet joints in the spine. Facet joint pain can be caused by a variety of conditions, including: 

  • Facet joint arthritis: inflammation of the facet joints due to wear and tear or age-related degeneration. 
  • Degenerative disc disease: a condition that occurs when the discs in the spine start to break down, causing pain and stiffness. 
  • Herniated disc: when the soft inner material of a disc in the spine protrudes outward and presses on a nerve, causing pain. 
  • Spinal stenosis: a narrowing of the spinal canal that puts pressure on the nerves in the spine, causing pain and other symptoms. 

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Endoscopic facet rhizotomy may also be used to treat other conditions that cause chronic back pain, including sciatica, spondylolisthesis, and failed back surgery syndrome. It is important to note that endoscopic facet rhizotomy may not always be appropriate for everyone and should only be recommended by a qualified physician after a thorough evaluation and consideration of other treatment options. 

How to Prepare for a Rhizotomy  

Preparing for a rhizotomy procedure typically involves the following steps: 

  • Consultation with a doctor: Before undergoing a rhizotomy, it is important to consult with a qualified physician who can evaluate your medical history, perform a physical exam, and determine if the procedure is appropriate for your condition. 
  • Medication management: Your doctor may advise you to stop taking certain medications, such as blood thinners or aspirin, before the procedure. You should also inform your doctor of any medications or supplements you are taking. 
  • Fasting: You may be asked to refrain from eating or drinking anything for several hours before the procedure. 
  • Arrangements for transportation: Since a rhizotomy is typically performed under sedation, you will need to arrange for transportation to and from the medical facility. 
  • Dress comfortably: Wear loose-fitting, comfortable clothing that allows for easy movement and access to the area where the procedure will be performed. 
  • Arrange for help at home: You may need to arrange for someone to help you at home after the procedure, as you may experience some temporary numbness or weakness in the affected area. 

It is important to follow your doctor’s specific instructions for preparing for a rhizotomy procedure to ensure the best possible outcome and minimize any potential risks or complications. 

How is a Rhizotomy Performed?  

An endoscopic facet rhizotomy is a minimally invasive procedure that is typically performed as an outpatient procedure, and it generally involves the following steps: 

  • Anesthesia: Before the procedure, the patient is given anesthesia to numb the area where the procedure will be performed. 
  • Incision: A small incision is made in the skin above the affected facet joint. 
  • Endoscope insertion: A small endoscope (a thin, flexible tube with a camera and light on the end) is inserted through the incision and guided to the affected facet joint. 
  • Visualization: The surgeon uses the endoscope to visualize the joint and surrounding structures. 
  • Nerve ablation: The surgeon uses a radiofrequency probe, which emits heat energy, to destroy or ablate the nerves that transmit pain signals from the facet joint. The heat creates a lesion or scar that prevents the nerve from transmitting pain signals. 
  • Closure: The endoscope is removed, and the incision is closed with sutures or adhesive strips. 

The procedure typically takes between 30 minutes to one hour to complete, and the patient is usually able to go home the same day. Recovery time varies, but most patients can return to their normal activities within a few days after the procedure. 

Benefits Of Endoscopic Facet Rhizotomy Procedure 

The benefits of getting an endoscopic facet rhizotomy procedure include: 

  • Long-lasting pain relief: The primary benefit of rhizotomy is that it can provide long-lasting pain relief for patients with chronic back pain. By ablating the nerves that transmit pain signals from the joint, patients may experience significant relief from pain and discomfort. 
  • Minimally invasive: Endoscopic facet rhizotomy is a minimally invasive procedure that involves only a small incision. Compared to other surgical options, endoscopic facet rhizotomy is less invasive, has fewer risks and complications, and can be performed with very little scarring. 
  • Outpatient procedure: Endoscopic facet rhizotomy is typically performed as an outpatient procedure, which means patients can usually go home the same day and recover in the comfort of their own homes. 
  • Quick recovery: Recovery time from rhizotomy is generally quick, and most patients can return to their normal activities within a few days. 
  • Improved quality of life: By providing long-lasting pain relief, endoscopic facet rhizotomy can significantly improve the quality of life for patients suffering from chronic back pain. Patients may be able to return to work or participate in activities they were previously unable to do due to their pain. 

When Is an Endoscopic Facet Rhizotomy Recommended?  

An endoscopic facet rhizotomy is typically recommended for patients who have chronic back pain that originates from the facet joints and has not responded to more conservative treatments such as physical therapy, medication, or injections. The procedure may also be recommended for patients who are not candidates for other surgical options due to certain underlying health conditions or who wish to avoid more invasive surgery. 

How Long Is the Recovery and How Soon Can You Return to Work?  

Recovery from a rhizotomy can vary depending on the patient’s individual circumstances and the type of procedure performed. However, in general, most patients can expect to return to their normal activities within a few days after the procedure. Patients may experience some mild discomfort, swelling, or bruising at the site of the incision, but these symptoms usually subside within a few days. 

Most patients are advised to avoid strenuous activities, heavy lifting, or twisting for a few weeks after the procedure to allow the incision site to heal properly. Patients may also be advised to attend physical therapy to help improve strength and flexibility in the affected area. 

The amount of time it takes to return to work can vary depending on the patient’s occupation and the physical nature of their job. Patients with more sedentary jobs may be able to return to work within a few days after the procedure, while those with more physically demanding jobs may need to take a few weeks off to recover. It is important to discuss return-to-work plans with your doctor to ensure that recovery is progressing appropriately and that you do not risk reinjury. 

Side Effects and Complications of a Rhizotomy 

As with any medical procedure, there are potential side effects and complications associated with a rhizotomy. Some of the most common side effects may include: 

  • Pain or discomfort at the site of the incision 
  • Numbness or tingling in the affected area 
  • Muscle weakness or loss of function 
  • Infection 
  • Bleeding or bruising at the site of the incision 

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While extremely rare, there is also a possibility for more serious complications, including:  

  • Nerve damage or injury 
  • Allergic reaction to anesthesia or other medications 
  • Accidental injury to other tissues or organs during the procedure 
  • Failure to achieve pain relief or recurrence of pain after the procedure 

Patients should always discuss the potential risks and benefits of a rhizotomy with their doctor before undergoing the procedure. By carefully evaluating the patient’s individual medical history and taking appropriate precautions, your doctor can minimize the risk of complications and ensure a safe and successful procedure. To learn more about Endoscopic Facet Rhizotomy or to see if you’re an ideal candidate for this procedure, contact the experts at Lonseth Interventional Pain Centers today.