Endoscopic
Rhizotomy

This advanced endoscopic ablation technique provides two major advantages over standard radiofrequency lesioning techniques. First, the endoscope provides direct visualization of the nerve so your doctor can confirm that the nerve has been accurately targeted. Second, a specialized endoscopic radiofrequency probe is used to precisely cut a segment of the nerve to and destroy the pain causing nerve roots using radiofrequency waves. This provides the patient with more complete pain relief that lasts longer than traditional radiofrequency ablation procedures.

Your doctor may attempt to help reduce your pain using a facet joint injection first. This will deliver an anesthetic and a steroid to the affected facet joint. If you feel some level of relief, then your doctor will know we are treating the correct pain source. The facet joint may deliver enough pain relief for you or the pain relief may not last very long. In this case, we will move to endoscopic rhizotomy.

Endoscopic rhizotomy is an outpatient surgical procedure. Your vital signs will be obtained by our staff who will also review your medical history and medications. An IV will be started to sedate you. Your blood sugar and coagulation status may be checked if needed. 

The procedure is performed utilizing deep sedation where you will feel as though you are asleep until waking up in the recovery area. Unlike traditional radiofrequency ablation procedures, the physician can directly visualize all relevant anatomy so you don’t need to be awake for motor or sensory testing or feedback. Very small incisions are made over the area of the painful joint and a small camera is inserted into the spine. The doctor is guided by fluoroscopic x-ray to correctly place the camera. Since the doctor is able to fully visualize the anatomy rather than relying on x-rays, less harmful radiation is used than during traditional radiofrequency ablation.

The camera allows the physician to see inside the spine where the nerve is. If the nerve is in a different position of the spine than usual, it can easily be located at the time of the procedure. The doctor uses a microscopic cauterizing instrument to find the small nerve branches that supply the joints in the spine. Once the nerve is identified, a small section is cut from the nerve to prevent any regrowth. If desired, the camera can also visualize the affected joint itself to provide visualized regenerative treatment. 

The camera is removed and the incision is closed with an absorbable suture. The procedure takes about 45 minutes to complete, but may take longer depending on how many nerves need to be treated. A rhizotomy provides several months of relief from back pain before the nerve regenerates, at which time, the procedure may be repeated.

Suffering from chronic back pain can interrupt your life and leave you unable to perform everyday activities. The pain specialists at Clearway Pain Solutions want to help you find relief so you can get back to living your life. Endoscopic rhizotomy can treat a variety of conditions including:

• Lumbar facet joint pain that has temporarily responded to lumbar medial branch blocks
• Thoracic facet joint pain that has temporarily responded to thoracic medial branch blocks
• Sacroiliac joint pain that has temporarily responded to SI joint injections
• Post surgical back pain that has had temporary relief following lumbar medial branch blocks
• Facet pain that has failed traditional radiofrequency ablation due to unique anatomy or insufficient duration

Contact Clearway Pain Solutions to schedule a consultation to treat your pain. Our expert team can help get you back to a pain free life.