What types of rhizotomy surgeries are available?

• January 7, 2020

When it comes to treating pain in your spine caused by tender joints, one of the most common procedures is a rhizotomy. Rhizotomy is a minimally invasive alternative to spinal fusion for reducing pain radiating from the facet joints caused by osteoarthritis and other conditions.

The main objective of rhizotomy is to reduce pain by severing the nerve branches in your facet joint that transmits pain signals to your brain. There are two types of rhizotomy procedures available: direct visualized rhizotomy and radiofrequency ablation. Both share the same main objective, but they take a different approach.

Direct visualized rhizotomy

Direct visualized rhizotomy, sometimes known as endoscopic rhizotomy, is an ultra-minimally invasive procedure that involves the use of an endoscope. An endoscope is a long, thin telescope with a high-definition camera attached at the end.

During a direct visualized rhizotomy, your surgeon makes a small incision (no bigger than 5 millimeters – the width of a paperclip) near the swollen facet joint. He or she will insert the endoscope and locate the nerve branches to the facet joint using images that the endoscopic camera transmits to a screen in the operating room.

Once your surgeon locates the nerve branches, he/she will sever them with microscopic instruments that also fit through the small incision in your back. After the nerves are severed, the endoscope is removed and the incision is closed with glue. You should be ready to go home within an hour.

Radiofrequency ablation

Radiofrequency ablation is the more traditional form of the procedure that relies on X-rays for locating the nerve branches in your facet joint. There is no direct visual, and instead of severing the nerve, the surgeon heats the nerves with a needle. This procedure is more minimally invasive than spinal fusion and other major spinal surgeries.

Which is better – direct visualized rhizotomy or radiofrequency ablation?

Direct visualized rhizotomy is a more accurate form of rhizotomy since it provides doctors with a direct visual of the nerves, and the nerve is cut and not burned. The relief from direct visualized rhizotomy is permanent. Most people who undergo direct visualized rhizotomy notice a reduction of pain immediately after the surgery. Only 60% of radio-frequency ablation patients notice relief from the procedure, and it wears off after an average of six months.

The results of direct visualized rhizotomy are much more long term. It relieves pain from the cut nerve fiber permanently, while radio-frequency ablation is temporary.

At Phoenix Spine & Joint, we believe that when it comes to medical procedures, it’s better to be able to see what you’re doing. Our surgeons are highly skilled in performing the procedure. Our patients feel well enough to walk within an hour after the surgery and can count on permanent relief. Contact our team today to learn more about direct visualized rhizotomy or schedule a free second opinion.