Rhizotomy (Radiofrequency Ablation)
A rhizotomy is a procedure done to treat pain in the neck or lower back. It uses radiofrequency energy to burn the small nerves that provide sensation to the small joints in the spine. A special needle is placed by the joints of the spine using x-ray guidance. Then, an electrode is inserted into the needle to deliver the radiofrequency energy to the target area. Radio waves produce an electrical current that heats the small area of nerve tissue around the tip of the needle, which in turn interrupts the pain signals.
Who is a candidate for a rhizotomy?
A rhizotomy is an option for patients who have arthritic back pain and a diagnostic response to medial branch blocks or facet injections. We use these injections to screen who should respond well to the rhizotomy procedure. If a patient does not have any pain relief with the medial branch blocks/facet injections, then we would not proceed with a rhizotomy.
What to know before the procedure:
- The rhizotomy procedure is performed in the Traverse City office procedure suites, using x-ray guidance. The procedure typically takes approximately 30 minutes to complete.
- We do not use general sedation. There may be some minimal discomfort throughout the procedure, but we try to minimize this with local anesthetic.
- Your back may remain sore for up to a week following the procedure. After the first week pain typically subsides and the pain relief may last anywhere from 6 months to a year, or sometimes longer. The procedure may not be permanent, as the nerves can regenerate, which may require a repeat procedure in the future.
- If the rhizotomy needs to be performed on both sides of the spine, you will have this scheduled as two appointments 1-2 weeks apart.
- Rhizotomy procedures are covered by most insurance plans. Co-pays and deductibles will vary based on each plan. Coverage can be discussed with our billing department prior to the procedure if you have any questions.
The day of the procedure:
- Please have a driver.
- If you are on coumadin, we do not require you to stop the medication, but please have an INR drawn the day before the procedure. If the level if too high, we may need to reschedule to prevent bleeding complications.
- You do not need to be fasting. We encourage you to eat a light meal or snack prior to the procedure.
- Injected medications may include anesthetic type medications (lidocaine, Marcaine), corticosteroid (Depo-Medrol, Celestone). If you have known ALLERGIES to any of these medications, please notify the office at least five days prior to the scheduled appointment for special instructions.
Post injection instructions:
- You do not have specific limitation following the rhizotomy procedure, but we generally recommend you take it easy for the first few days.
- Ice is recommended for any post-procedural pain.
- Normal activity can be resumed when tolerated.
