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Rhizotomy / Nerve Ablation
Rhizotomy is a surgical procedure to sever nerve branches in the spinal cord. The procedure effectively relieves chronic back pain and muscle spasms. For spinal joint pain, a facet rhizotomy may provide lasting low back pain relief by disabling the sensory nerve at the facet joint.
A facet rhizotomy may help to relieve pain by "turning off" the pain signals the spine's facet joint(s) send to the brain. To help you prepare for the procedure:
- Your physician will give you detailed instructions about whether you can eat before the procedure.
- In most cases, you can continue to take your usual medications before a rhizotomy. However, make sure you discuss what medications you use with your physician before the procedure.
- Since a rhizotomy requires the use of a local anesthetic or sedation, you may need someone to drive you home after the procedure.
About the Procedure
The procedure begins with a mild sedative administered intravenously (by IV) to keep you comfortable but awake during the procedure. A local anesthetic is injected to numb the procedure site.
Your pain physician utilizes fluoroscopy (real-time x-ray) to guide the placement of the needle (electrode). Once the needle is in place, a mild electrical current stimulates the nerve and confirms its exact location. You may feel slight pressure or tingling during this part of the procedure. Then the electrode is heated to deaden the sensory nerves. When the procedure is completed, the needle is removed and the injection site is bandaged.
A procedure performed with local anesthesia (or IV sedation when needed), needle, X-ray, and radiofrequency waves to remove the sensory nerves that cause pain. These are the nerves that send signals to the brain telling it your back hurts.
The destruction (also called ablation) of nerves is a method that may be used to reduce certain kinds of chronic pain by preventing the transmission of pain signals. It is a safe procedure in which a portion of nerve tissue is destroyed or removed to cause an interruption in pain signals and reduce pain in that area. Nerve ablation can be done in different ways.
For example, it can be done using heat, cold, or chemicals. What the procedure is called depends on how it is done. For example, it may be called radiofrequency ablation, cryoablation, neurotomy, or rhizotomy.
Your doctor will first identify the nerve or nerves that are sending pain signals to your brain. You will have a test that uses a nerve block, which numbs specific nerves, to help your doctor find the nerves that are causing your pain.
During the procedure, you may have X-rays to pinpoint where to put the medical tool that will be used. After you receive a local anesthetic, the doctor places the medical tool under your skin through which the nerve tissue is removed or destroyed. Depending on how the ablation is done, it may cause you to feel a buzzing or tingling sensation. The damage to your nerves blocks them from sending pain signals to your brain. But the nerve often tries to grow back. If it does, the results are only temporary and usually last for around 6 to 9 months.
This procedure is done in an operating room and takes between 20 minutes to 1 hour or longer depending on how many, and which, nerves are being blocked. If the nerve that is blocked is not the nerve that is causing the pain, your pain will not be reduced.