Radiofrequency rhizotomy, also known as neurotomy, is a minimally-invasive procedure for treating nerve pain in the spine. The procedure works by sending pulses of heat energy generated by radio waves to the affected nerves. The goal is to stop these nerves from processing pain signals from injured facet joints, the small joints located between the vertebrae.
Normally this method of pain management is not used unless the patient's nerve pain has not responded to other more conservative treatments, such as anti-inflammatory medication or physical therapy. The goal of a radiofrequency rhizotomy is to reduce back pain without reducing nerve function. Diagnostic testing is usually performed before the procedure to make sure precisely which nerves are causing the problem.
The Radiofrequency Rhizotomy Procedure
During a radiofrequency rhizotomy, the patient lies facedown. The procedure is outpatient, performed either under general anesthesia or under local anesthesia with intravenous sedation. It takes approximately one hour. After numbing the site, the surgeon uses a small needle to penetrate the skin covering the spine. The highly focused heat targets the affected nerve(s), preventing pain signals from being transmitted to the brain.
Fluoroscopy, an imaging technique, is used during the process to ensure that the small needle is inserted accurately into the appropriate facet. Depending on the patient's condition, the needle may be inserted into more than one place on the spine.
After the Radiofrequency Rhizotomy
Patients should be able to resume normal activities the day after the procedure, although they may expect some soreness, numbness, itchiness or weakness in the targeted region for a few weeks. After about 3 weeks, they should be pain-free. As with most pain management treatments, radiofrequency rhizotomy does not work equally well for all patients. While symptom relief from the neurotomy is always temporary, it may provide comfort for several months or for more than a year.
Risks of a Radiofrequency Rhizotomy
While the procedure is generally considered a safe one, because nerves are affected there is some element of risk. Although extremely rare, serious complications are possible, including long-term numbness, bladder or bowel incontinence and even paralysis.