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Spinal Pain Management

Rhizotomy

Median branch rhizotomy is a minimally invasive procedure to treat neck and back pain resulting from facet arthritis. The ideal candidate for facet rhizotomy has had a facet block or median branch block which was successful in providing temporary relief, thereby confirming that the facet joint is the major source of the patient’s pain.

A rhizotomy is performed by placing a small needle, through the skin, and to the nerve that carries nerve signals from the inflamed facet joint. Importantly, each facet joint is served by two nerves. Each nerve must be treated for a successful rhizotomy. The needle has an electrode at its tip. Energy, in the form of a radiofrequency, is applied to the electrode. This causes heating of the nerve, shutting off painful signals coming from the facet joint.

If successful, pain relief lasts 3 to 6 months, or in some cases up to a year. However, it may take 6 weeks for the effects of facet rhizotomy to take hold and provide significant pain relief.

This image shows how ablation needles are positioned in the cervical spine for median branch ablation, or rhizotomy

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