Rhizotomy: What Every Patient Needs to Know

If your doctor has suggested that you should consider a rhizotomy to relieve your back pain, you’re sure to have questions. Is it safe? Is it painful? Will I be out of work for very long? Here’s everything you need to know.

What is a Rhizotomy?

In simple terms, a rhizotomy means cutting the nerve roots that carry pain signals to the brain. The nerve roots are severed where they enter the spinal cord. When these nerve roots are “disconnected,” the pain signal can no longer reach the brain, so you no longer feel the sensation of pain. The procedure, also called radiofrequency ablation, is used to relieve chronic back pain and provides relief for 9 months and, in some cases, up to 3 years or more. The rhizotomy can be repeated, if needed.

Rhizotomy is a minimally invasive procedure, so it is usually performed in an outpatient surgical center. Heat is used to burn the nerve roots that are causing the back pain. Patients who undergo rhizotomy receive almost immediate pain relief, so the need for pain medication is usually significantly reduced. There is little or no recovery time.

A rhizotomy is something your doctor may suggest if you’ve experienced chronic back pain, especially in the lower back (lumbar spine) or neck (cervical spine) after other more conservative measures have failed. This procedure offers some advantages over other treatments:

• With a rhizotomy, the surgeon can actually see the nerves that are causing the problem and target them precisely.
• Many patients treated with rhizotomy experience more long-term relief than with other pain management options.

Rhizotomy is not recommended for patients who have an infection, are pregnant, or have a bleeding disorder.

How to Prepare for a Rhizotomy

Most patients receive intravenous (IV) sedation. If this is the case, you’ll be instructed not to eat or drink for a period of time before the rhizotomy procedure. You’ll also need a family member or friend to drive you home. Be sure that your doctor is aware of all of your medications that you take, and ask about which medications you should take—and which you should not take—before the procedure. Patients who are taking blood thinners or aspirin products may need to discontinue these medications temporarily before undergoing a rhizotomy.

How is a Rhizotomy Performed?

A rhizotomy takes between 30 minutes and an hour. You’ll be awake during the procedure so that you can provide feedback to the doctor but, if you’ve been given a mild sedative, you will be comfortable. Most patients feel pressure but do not experience pain during a rhizotomy.

The surgical site will be numbed using local anesthesia. A 1/4-inch incision will be made near the facet joint of the vertebrae. Using an X-ray image as a guide, the doctor will thread a tiny needle through the incision until it is properly positioned at the tip of the nerve where the pain originates. A numbing medication will be injected and then a radiofrequency current will be transmitted to the tip of the needle to precisely burn the nerve root. This procedure will be repeated on any other nerve sites if more than one site is producing pain.

After the rhizotomy is complete, the needle is removed, and a small bandage is placed over the incision. There is usually no need for stitches.

Recovering from a Rhizotomy

After a rhizotomy, patients can usually return to work and normal activities the next day, but should avoid any strenuous activity or heavy lifting for a day or two. Taking a shower is permitted but bathing, swimming, or soaking in a hot tub should be avoided for the next 24 hours.

Some patients experience mild discomfort, bruising, soreness, or swelling after a rhizotomy. The discomfort may linger for a few days to up to a couple of weeks. An ice pack and over-the-counter pain reliever are usually all that is needed.

Patients who have had a rhizotomy can expect their previous pain levels to improve gradually after the procedure is performed. Full recovery and maximum pain relief may take a couple of weeks.

Side Effects and Complications of a Rhizotomy

Rhizotomy is a safe procedure. Side effects and complications are rare. If you do experience any of these symptoms, contact your doctor:

• dizziness or weakness
• fever, chills, nausea, or vomiting
• redness, swelling, bleeding, or drainage at the injection site
• numbness that lasts for more than 2 or 3 hours

The only way to determine if a rhizotomy is the right choice to ease your chronic back pain is to consult with a skilled spine specialist. The spine specialists at Inspired Spine are here to help you.