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Radiofrequency (RF) Rhizotomy or Neurotomy

Radiofrequency (RF) rhizotomy or neurotomy is a therapeutic procedure designed to decrease and/or eliminate pain symptoms arising from degenerative facet joints within the spine. The procedure involves destroying the nerves that innervate the facet joints with highly localized heat generated with radiofrequency. By destroying these nerves, the communication link that signals pain from the spine to the brain can be broken.

Preliminary Testing

Before an RF rhizotomy exam can be scheduled, it is important for our physicians to verify the areas where the pain originates. Exams required to determine these areas might include MRI of the spine, facet nerve injections with local anesthetic (numbing) and steroid (anti-inflammatory) medication, and possibly discography.

Procedure Preparation

When it is determined that you are a candidate for this procedure, you will schedule an appointment with our staff at a local hospital or surgery center.

Please bring any previous imaging study results (MRI, CT, x-rays) such as films, reports, or CD-ROMs, to your initial appointment. If you do not have current images, we may refer you to have them done prior to the procedure.

If you choose IV sedation you will receive specific instructions to follow prior to the procedure with regard to eating and drinking.

If sedated, you will need someone to drive you home and stay with you for 12 hours post-procedure due to the effects of the medications.

Please notify our physician if you are nursing or if there is a chance you may be pregnant.

Please be prepared to discuss any medications that you are currently on with our physician, or bring your medication bottles with you to your appointment.

During the Procedure

RF rhizotomy is an advanced injection procedure.

It's important that you remain awake during the procedure to provide important feedback to your physician.

A thin needle electrode will be placed adjacent to the degenerative facet joint.

Accurate placement of the needle will be assured by using a fluoroscope (x-ray camera), which is connected to a T.V. monitor.

To verify the needle position, the nerve may be stimulated using low voltage electricity. The stimulation will cause the affected muscles to rhythmically contract.

Numbing medication (anesthetic) will be injected to put the nerve to sleep.

Heat will be applied to the nerve via the electrode for approximately 60 seconds.

This heat is designed to create a lesion, causing the nerve to become cauterized or burnt, which in turn breaks the communication link to the brain.

This procedure is then repeated at other levels, including the levels above and below where the pain is originating.

Throughout the procedure, a physician and nurse will monitor your condition and comfort level closely.

After the Procedure

Due to the sedation, a nurse will review some guidelines that you will be asked to follow post-procedure.

You may experience numbness and/or relief from symptoms for 2-8 hours after the procedure due to the anesthetic.

Once the local anesthetic effects have worn off, your usual symptoms may return and may be more severe for up to 5-7 days after the procedure.

You should keep a record of symptoms following the procedure and report to the referring physician at your follow-up appointment.

Some patients will experience elevated pain for up to 4 weeks after the procedure.

Improvement can be expected 2-3 weeks after the procedure, but in some cases, it may take up to four weeks before the beneficial effects and decrease in pain is achieved.

A full course of physical therapy will help you to fully recover, strengthen your back and core muscles, and maximize your recovery.