Rhizolysis or radiofrequency denervation, also known as facet rhizolysis, is a procedure performed on the nerves of the joints of the spine. These nerves alert the brain of back pain. Rhizolisis uses a technique known as radiofrequency that is applied through a special needle. The heat produced by the radiofrequency at the tip of the needle will interrupt the pain reported by the nerves, the pain that you as a patient experience. The procedure is done in an attempt to provide long-term relief. However, after a period of time, the nerve will regenerate and therefore the pain may return.
The facet joints are small joints located symmetrically at each vertebral level of the spine. Each facet joint is served by two nerves that carry various types of messages such as sensation, movement, and pain from the spine to the brain, which is where we process and perceive pain. By blocking these nerves, we try to block pain messages at the point where they originate so that they do not reach the brain. This way, we manage to alleviate the experienced pain.
In some cases, it may be necessary to verify by means of pharmacological blockade (an anesthetic), that it is the joints and nerve branches that are producing the pain.
Success rates vary but generally around 50% of patients undergoing this procedure will experience significant pain relief over the next six months to up to two years. However, after a period of time, the nerve will regenerate and the pain may return.
Another 25% of patients will get some pain relief for a shorter period.
Pain relief may take 2-3 weeks to reach its maximum effect. However, it is highly unlikely that you will get complete pain relief, since not all pain is generated in the joints. There is the possibility that in a small number of patients, the procedure will have no effect. There is a 5% risk that the pain will worsen permanently.
Pain relief improves quality of life and allows normal activities to be carried out, as well as facilitating possible physiotherapy if indicated.
The procedure is performed in the operating room as an out-patient procedure, which means that hospital admission is not necessary. After the procedure and after a short period of rest, you can go home.
The procedure is performed under X-ray supervision and local anesthesia. In some cases, sedation can be added as long as it does not hinder the patient´s collaboration with the doctor during the procedure, which is necessary.
In the case that the patient is female of childbearing age, please inform us if you may be pregnant.
The procedure consists of the following steps:
The whole procedure takes approximately 20 to 40 minutes.
Complications from this procedure are very rare. However, they could occasionally occur and would include:
It is important to know if you take any type of antiplatelet medication (non-steroidal analgesics in general or aspirin) or anticoagulants.
A lumbar rhizolysis is an out-patient procedure, therefore you can return home after a short rest (30-60 min) in the hospital. You will be asked to rest for the rest of the day and to avoid activities that involves physical effort for the next two days. You may notice some soreness or numbness in the area where the treatment was performed, this will be short-lived. On rare occasion, the pain you felt prior to the intervention may worsen. Pain relievers may be used to treat pain. Ice or heat may also be applied to relieve discomfort. Remember that it may take up to 2-3 weeks for the procedure to take full effect, with a positive result in 50-75% of the cases. If the pain returns, a second procedure can be performed or, once your case has been studied, other treatments could be considered.
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