Radiofrequency rhizotomy or neurotomy is a therapeutic procedure designed to decrease and/or eliminate pain symptoms arising from degenerative facet joints or sacroiliac joints within the spine. The procedure involves destroying the nerves that innervate the joints with highly localized heat generated with radiofrequency energy. By destroying these nerves, the communication link that signals pain from the spine to the brain can be broken.

Preliminary Testing

Before an RF can be scheduled, it is important for our anesthesiologists to verify the areas where the pain originates. Exams required to determine these areas might include MRI of the spine, facet nerve injections with local anesthetic (numbing medication) and steroid (anti-inflammatory medication), and possibly discography.

During the Procedure - What to Expect

• RF rhizotomy is an advanced injection procedure.
• It's important that you remain awake during the procedure to provide important feedback to the anesthesiologist.
• An anesthesiologist will perform the procedure using a thin needle electrode placed adjacent to the degenerative facet joint.
• The anesthesiologist 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 stimulation will cause the affected muscles to rhythmically contract.
• The anesthesiologist will then use numbing medication (anesthetic) to put the nerve to sleep.
• Then the anesthesiologist will apply heat to the nerve via the electrode for approximately 60 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, an anesthesiologist and nurse will monitor your condition and comfort level closely.

After the Procedure - What to Expect

• Due to the sedation, a nurse will review some guidelines that you will be asked to follow post-procedure (pertaining to driving, drinking alcoholic beverages, etc.).
• 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.
• You should keep a record of symptoms following the procedure and report to the referring physician at your follow-up appointment.
• Patients must understand that approximately 10-12 percent 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 rhizotomy are noted and a decrease in symptoms is realized.