Radiofrequency (RF) Rhizotomy
Radiofrequency (RF) Rhizotomy is a therapeutic procedure designed to decrease and/or eliminate severe pain from degenerative facet nerves within the spine. Your pain symptoms may be along your neck, back or low back.
What are the anticipated benefits?
RF Rhizotomy is a therapeutic procedure that does not treat the root cause of pain, but rather is designed to decrease or eliminate pain completely by applying highly localized heat to burn the nerve and therefore break the pain signal from the spine to the brain.
How does it work?
Preliminary Testing - Before a RF Rhizotomy exam should be performed, our radiologists need to verify the areas where the pain originates. Exams required to determine these areas might include MRI of the spine, facet nerve injections or discography.
RF Rhizotomy takes approximately 60-90 minutes. However, you will be asked to wait an additional 30-40 minutes after the procedure so that the clinic staff can monitor your symptoms.
You will be positioned on a special table in our Diagnostic and Therapeutic Injections (DTI) suite. The C-arm (a special x-ray machine) can be rotated to allow the radiologist to monitor the injection to make sure he is precise in targeting the pain source. In addition, the table can be easily rotated to help the contrast dye move to the area of interest.
All RF Rhizotomy patients will receive sedation. Once you arrive, you will have an I.V. needle placed in your arm so that you can receive the medication. You will be awake during the procedure to provide important feedback to the radiologist, but the sedative will help diminish anxiety and any discomfort.
One of our specialized radiologists first numbs a small area of skin with a numbing medicine (anesthetic). He will then place a thin needle electrode adjacent to the degenerative facet joint.
The radiologist will check the needle placement using a fluoroscope (x-ray camera), which is connected to a T.V. monitor. X-rays will be taken at this time. To verify the needle position, the nerve may be stimulated using low voltage electricity. The radiologist will then use numbing medication (anesthetic) to put the nerve to sleep.
Then the radiologist will apply heat to the nerve via the electrode for approximately 90 seconds. This heat is designed to create a lesion, causing the nerve to become cauterized or burnt, which in turn breaks the communication link to the brain.
This procedure is then repeated at other levels including the levels above and below where the pain is originating. Throughout the procedure, a radiologist and nurse will monitor your condition and comfort level closely.
Are there any risks or negative side affects?
You may experience numbness and/or relief from symptoms for 2-8 hours after the procedure due to the anesthetic. Once the local anesthetic effects have worn off, your usual symptoms may return and may be more severe for up to 5-7 days after the procedure.
Approximately 10-12% of those people who have undergone RF procedures experience elevated pain for up to four weeks, rather than improvement.
Improvement is usually noticed by the 2-3 week after the procedure. However, it may take up to four weeks before the beneficial effects of the RF Rhizotomy are noted and a decrease in symptoms is realized.
NOTE: This procedure is not performed in our St. Louis market.
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