What is Radiofrequency Lesioning (Rhizotomy)?
What is a Rhizotomy (RFR) and why is it helpful?
This procedure is done to treat pain caused by the facet joints by creating a lesion or burn in the pain fibers to the facet joint, also known as the medial branch of the posterior primary ramus. The purpose of RFR of the medial branch is to decrease pain and improve function. This is done only if pain is relieved temporarily by medial branch nerve blocks.
How is it done?
It is accomplished by placing a special needle alongside the facet joint under X-ray control. Following this, a controlled heat lesion is made to decrease the sensation of the facet joints. Nerve testing is performed to verify the proper position of the needle. An intravenous solution will be started so that medications or a short-acting sedative, if necessary, can be given during the procedure. The procedure will take approximately 20 – 60 minutes. You will then be monitored for an additional 30 – 60 minutes. All measures will be taken to ensure your comfort and safety. After you return home, you may use ice packs to relieve any discomfort.
General Pre/Post Instructions
You should have nothing to eat for seven hours prior to your procedure. Clear liquids can be taken up to four hours prior to your procedure. Please take your routine medications (i.e. high blood pressure and diabetic medications) with a sip of water at your usual time. If you are on Coumadin, Heparin, Plavix, or any other blood thinners you must notify the office so the timing of these medications can be explained. For your own safety, if you do not follow the above instructions your procedure may be cancelled. A driver must accompany you and be responsible for getting you home. No driving is allowed the day of the procedure. You may return to your normal activities the day after the procedure, including returning to work.
Prior to this procedure, a written consent will be obtained that will include the possible risks and hazards. Certain effects are to be expected: bruising at the injection sites, soreness and swelling. Possible side effects include burning sensation at the injection site, numbness, itching, and occasionally 2 – 3 weeks of increased pain. This is only temporary.