ENDOSCOPIC RHIZOTOMY
Medial branch nerves are very small nerves that innervate the facet joints of the spine. Facet joints are the joints connecting the different vertebrae of the spine to each other. The joints are present on both sides of the spine from the neck to the lower back.
The surgery takes the percutaneous radiofrequency ablation procedure (RFA), a common procedure where we use special needles and electrical current to turn off the nerves, an important step further by providing direct endoscopic visualization of the posterior spinal anatomy and nerves.
More Questions Patients Ask
How long does relief from an endoscopic rhizotomy last?
Because the procedure interrupts the small nerves that carry pain from the facet joints, relief typically lasts considerably longer than an injection, often many months. Those nerves can regenerate over time, so symptoms may gradually return and the procedure can be repeated. It manages pain from the joint rather than reversing the arthritis in it.
What are the risks?
Risks include soreness at the treatment site for a week or two, temporary numbness over the skin of the back, and a small chance of infection, bleeding or nerve irritation. A minority of patients experience little benefit, which is why a diagnostic block confirming the joint as the pain source is usually performed first.
How is this different from a facet injection?
A facet injection delivers medication to the joint and its effect is temporary. A rhizotomy treats the nerve supply to the joint, so the aim is a longer interval of relief. The injection generally comes first, both as treatment and to confirm that the joint really is the source before the nerves are treated.
Will I still need rehabilitation afterward?
Yes. Reducing pain creates a window in which strengthening and mobility work are finally tolerable, and using that window is what makes the relief last. Patients who treat the rhizotomy as the whole solution rather than as part of a plan tend to be back sooner.