What is Rhizotomy and How Does It Work?

Rhizotomy targets painful spine facet nerves. At each intervertebral segment, facets contain medial nerves. Medial nerves send pain signals to joints, but when they become swollen, they can be very painful. This is where rhizotomy "turns off" a sensitive nerve so that it doesn't send pain signals to the brain from the swollen facet joint.

What is Rhizotomy?

Rhizotomy is a slightly invasive surgery that gets rid of nerve pain by killing the nerve fibers that send pain signals to the brain. Nerve fibers can be destroyed by cutting them or burning them with chemicals or electricity. Rhizotomy generally takes away the pain right away and for years until the nerve heals and can send pain again. Rhizotomy, ablation, and neurotomy all remove or kill tissue.

Rhizotomy Types

Several kinds of rhizotomy cut nerve fibers that send signs of pain.

Rhizotomies can be done under general or local anesthesia with X-ray, fluoroscopy, or other image-guided techniques to ensure precision.

Glycerol/Glycerin Rhizotomy

In this type of rhizotomy, a pain doctor in Plano injects a small amount of glycerin or glycerol into the nerve root. It takes 45–60 minutes for the chemical to destroy nerve pain fibers.

RF Rhizotomy

Instead of using a chemical to destroy nerve fibers, radiofrequency rhizotomy (also known as radiofrequency ablation) burns them with a radiofrequency current. It is frequently utilized for patients who do not achieve full alleviation from glycerin or who have persistent discomfort and require assistance in navigating scar tissue.

Endoscopic Rhizotomy

Pain management in Dallas uses an endoscope to locate and sever the nerve fibers in endoscopic rhizotomy. The endoscope is introduced via a minor incision utilizing tubular retractor tubes. This lets the surgeon reach the nerve without damaging healthy tissues. The procedure is called direct visualized rhizotomy.

What Distinguishes Rhizotomy from Ablation?

Nerve ablation and rhizotomy both damage painful nerve fibers. The term rhizotomy is broad. Heat-based radiofrequency ablation (RFA) damages nerves. Chemical ablation using nerve-toxic material damages nerves.

Healthcare providers may use neurotomy instead of rhizotomy or nerve ablation.

What Rhizotomies Treats?

Rhizotomy procedures treat chronic pain and spasticity. Multiple rhizotomies target different nerves to treat specific pain causes. Chronic pain treatment with rhizotomies isn't recommended. The best pain specialist in Fort Worth usually starts with physical therapy, NSAIDs, or nerve blocks.

Phytotomy of Trigeminal Ganglion

This rhizotomy targets the trigeminal ganglia nerves bilaterally on your face. It aids in the treatment of: 

• Trigeminal pain.

• Cluster headaches that resist treatment.

• Idiopathic persistent facial pain.

• Facial postherpetic neuralgia.

• Cancer-related facial pain.

• Percutaneous rhizotomy is an alternative designation. A "percutaneous" operation is performed via the skin.

Facet Rhizotomy

This rhizotomy targets spine facet joint nerve roots. Rhizotomy for back pain can relieve chronic neck or lower back pain from spine conditions like arthritis and facet joint syndrome. Providers may call a neck nerve procedure a cervical rhizotomy. It may be referred to as a lumbar rhizotomy for the nerves in the lower back. 

Selective Dorsal Rhizotomy

Pediatricians may employ selective dorsal rhizotomy to address stiffness associated with cerebral palsy. Spasticity disrupts muscle movement patterns, causing certain muscles to contract simultaneously when moving or at rest. This rhizotomy targets lower spinal cord sensory nerve fibers. 

How Do I Prepare for Rhizotomy?

Different rhizotomies require different preparations. Your healthcare team will instruct you. Your pain specialist in your area will likely recommend tests to ensure the rhizotomy will help you. These tests may include imaging tests like:

• MRIs or X-rays.

• Locate problematic nerves with nerve blocks.

• Blood tests.

• Urinalysis.

For general anesthesia, you'll see an anesthesiologist to ensure your safety. This may include heart tests. Anticoagulants and other medications may need to be stopped. Again, your provider will inform you if this applies. Do not discontinue your medicines without consulting your physician of Dallas pain clinic. 

What Happens During Rhizotomy?

The type of rhizotomy—surgical cutting, radiofrequency ablation, or chemical ablation—and which nerves pain physicians in Dallas targets affect the procedure.

Typical rhizotomies include:

• Sedation or general anesthesia: The majority of rhizotomies necessitate general anesthesia, which anesthetizes the brain and induces sleep.

• Sedation or local anesthesia may be used for other rhizotomies.

• Imaging advice: Fluoroscopy is used in most rhizotomies to locate problematic nerves and ensure the needle is placed correctly. A safe contrast dye may be needed to highlight your nerves on imaging. IV dye injections are performed.

• ElectricL Stimulation: Electrical stimulation is used to test the affected nerves during rhizotomies to ensure they are the right nerves to target. Electromyography, or the insertion of a microelectrode via a hollow needle to stimulate the nerve, may be employed, contingent upon the type of rhizotomy.

• Chemical and radiofrequency ablations are usually given with needles. Nerve cutting requires open or endoscopic rhizotomy surgery.

A Note from Premier Pain Centers