Facet Rhizotomy

Facet Rhizotomy

Used to treat pain from facet joint syndrome, facet rhizotomy is a quick procedure that inserts an electrothermal needle into the joints and heats up the nerves to deaden them.

What is a Facet Rhizotomy?

  • Treats pain from spinal conditions that cause the facet joints to rub together and pinch a nerve root. The two main spinal conditions it treats include facet joint syndrome and arthritis of the spine.
  • Is a procedural technique that utilizes local anesthetic and X-ray imaging to guide a needle tipped with an electrode into the affected facet joint(s). The electrode then heats up and deadens the surrounding nerves, which reduces or eliminates pain signals sent to the brain.
  • Effects from the procedure can last at least 6 months, and may even last for years. The procedure is utilized when all other pain relief methods fail and the facet joints have degenerated.
  • Is minimally-invasive, takes less than an hour to complete, and creates only a small hole with the needle.

Facet rhizotomy, also known as radio frequency nerve lesioning, is an approach to pain relief from pain caused by facet joint syndrome and arthritis of the spine, or osteoarthritis. Patients with degenerated facet joints generally experience pain from the joints rubbing together and pinching a nerve root. Facet rhizotomy aims to block the pain signals from the pinched nerve to the brain by deadening the joint's surrounding nerves.

The procedure involves inserting a needle with an electrode tip percutaneously (from the back) into the joint to gradually heat up the nerves. The high temperature deadens the nerves, which stops the nerves from sending signals of pain to the brain. Patients may feel pain relief within hours of the procedure, and may be relieved of all or most pain for at least 6 months.

A facet rhizotomy may alleviate pain experienced in patients who have exhausted conservative and semi-conservative methods of treatment. Usually, patients have tried facet joint injections, but have found their pain only decrease an insignificant amount. Facet rhizotomy may commonly relieve pain felt in the back, limited motor skills, and the patient's lower quality of life.

What does it treat?

  • Facet Joint Syndrome
  • Arthritis of the Spine (Osteoarthritis)
  • Spondylosis

Who are good candidates?

Ideal candidates for a facet rhizotomy must have tried conservative and semi-conservative methods of treatment before choosing to undergo the procedure. Some patients have tried steroidal injections into their affected facet joints, but did not find significant relief. Patients should have experienced pain for at least 3 to 6 months, and should experience one or more of the following symptoms:

  • Chronic pain of varying strength felt in the different sections of the back that is either sharp, shooting, throbbing, or dull
  • Pain that radiates from the mid-back and into the ribs and chest, from the lower back and into the buttocks, legs, calves, feet, and toes, or from the neck and into the shoulders, arms, hands, and fingers
  • Limited motor function skills
  • Trouble walking, standing, or sitting
  • Limited ability to perform everyday activities
  • History of conservative methods of treatment that have failed to treat the pain and heal the patient's spinal condition

Additionally, patients should be optimistic towards effective pain management.

What is the procedure like?

Facet rhizotomy is a quick procedure that takes just 30 to 60 minutes to complete. Patients are under local anesthesia and only need a topical anesthetic throughout the procedure.

The following are the general steps for a facet rhizotomy:

  • Local anesthetic is administered to the patient on the area where the needle will be inserted into the back.
  • A needle with an electrode tip is inserted into the area with assistance from an X-ray machine.
  • The needle is guided and placed alongside the small nerves of the facet joint.
  • The electrode tip is then gradually heated via radiofrequency, until the nerves that carry the pain signals to the brain are deadened.
  • Once the nerves are blocked, the needle is removed, and the procedure ends.