Medical Director Andrew Will, M.D., regularly performs rhizotomy procedures for Twin Cities Pain Clinic patients. “We found that rhizotomy is one of the only procedures that gives long term relief from facet joint pain in the cervical [neck], thoracic [chest], and lumbar [low back] areas.“
Find out if you're a good candidate and what to expect when you have the procedure.
What Is Facet Rhizotomy?
The goal of a facet rhizotomy, either a cervical facet rhizotomy or lumbar facet rhizotomy, is to provide pain relief by "shutting off" the pain signals that the joints send to the brain. The pain relief experienced by most patients who have this procedure lasts months or even years without needing to repeat the procedure, making it one of the few procedures available for long-term relief.
How Facet Rhizotomy Is Done
A patient first needs to be determined a good candidate for the procedure. A facet nerve block injection will be given to the area causing pain. If the patient experiences substantial relief (80 percent or more), then a second test injection will be given. If the patient has similar results to the first test injection, than the patient is determined to be a candidate for rhizotomy. The test injections also used to verify the source and exact location of the patient’s pain.
Dr. Will performs the rhizotomy procedure at the clinic with the patient under mild sedation. Using a live x-ray, or fluoroscopy, Dr. Will guides a needle with an electrode at the tip to the sensory nerves causing pain at the facet joint and places it alongside the nerve. The electrode is then heated, with a technology called radiofrequency. It essentially deadens the nerves carrying pain signals to the brain. The procedure takes from 30 to 60 minutes. Afterwards, patients are monitored for a short period of time before being released. Serious complications with facet rhizotomies are rare.
A Brief History of Radiofrequency Rhizotomy
In the early 20th Century, just as we were beginning to understand and map out the body's nervous system, nerve connections were compared to a telegraph system. Impulses, which tell our brain what to feel, were thought to travel through the nerves like a telegram through a wire. The basic understanding was: if you cut the wire, the telegram doesn't get through, so if you cut the nerve, the pain message won't get through.
What causes the facet joints to become painful?
Osteoarthritis is probably the most common cause of cervical facet joint pain. This degenerative disease causes progressive cartilage deterioration. Without the spongy cartilaginous cushion, joint bones begin to rub against each other when at rest and during movement.
Another condition, Degenerative Disc Disease (DDD) may compromise the structural integrity of the intervertebral discs causing discs to lose normal height. Loss of disc height may cause the affected facet joints to become positioned too closely thereby disrupting the joint's ability to function normally.
In addition, rheumatoid arthritis, ankylosing spondylitis, spinal stenosis, injury, poor posture, and wear and tear may also contribute to a painful facet joint disorder.
Will Rhizotomy be right for you?
Radiofrequency rhizotomy isn't a "first line of defense" treatment for back pain or neck pain. Before RF is recommended to TCPC patients, our clinic starts patients on physical therapy, followed by facet nerve blocks and other spinal injections, and perhaps pain medications. We stress a physical therapy program first that works on postural correction and proper body mechanics because most neck pain and some back pain will respond well to physical therapy.
Source: SpineUniverse.com
Image Source: BostonPainCare.com
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