Rhizolysis for Chronic Spinal Pain: A Minimally Invasive Solution Backed by Experience

Rhizolysis, also known as facet joint denervation or radiofrequency ablation, is a minimally invasive treatment aimed at alleviating chronic lumbar and cervical pain. At our clinic, with over 25 years of experience treating complex spinal pathologies, including degenerative and post-surgical pain syndromes, rhizolysis has become a valuable tool in restoring quality of life for our patients.

Fluoroscopic image showing percutaneous lumbar radiofrequency rhizolysis targeting the medial branch nerves adjacent to the facet joints.
Illustration of facet joint anatomy showing the superior and inferior articular processes of adjacent vertebrae and the surrounding joint capsule.

What Is Rhizolysis?

Rhizolysis involves using radiofrequency energy delivered through a specialized needle to interrupt pain signals from the facet joints of the spine. These small joints, present at each vertebral level, are innervated by medial branch nerves that can become irritated due to arthritis, facet joint syndrome, or spinal degeneration.

This technique targets the nerves without affecting the structure of the joint. The goal is pain relief lasting several months to a couple of years, depending on nerve regeneration.

Our medical director, Dr. Vicenç Gilete, has applied this approach within a wider strategy of pain control, combining precise diagnostics, high-resolution imaging.

 

Indications for Rhizolysis

Rhizolysis is particularly indicated in patients with:

  • Chronic low back pain due to facet joint osteoarthritis
  • Cervical facet syndrome
  • Post-surgical spinal pain (failed back surgery syndrome)
  • Facet joint inflammation due to degenerative changes
  • Patients who had temporary relief after a diagnostic nerve block

 

At our center, every case is thoroughly evaluated using MRI and CBCT, ensuring the structural source of pain is precisely identified.

“With over 25 years of experience within the neurosurgical field, Dr. Gilete performs a variety of surgical procedures on the spine […] including cases of chronic pain with personalized strategies, combining diagnostics, imaging, and nerve-directed interventions.”

How the Procedure Works

The rhizolysis procedure is conducted under fluoroscopic guidance, ensuring safe and accurate needle placement. Here is a step-by-step overview:

  1. The patient lies face down.
  2. Local anesthesia is administered.
  3. A radiofrequency needle is inserted toward the target nerve.
  4. Once the correct position is confirmed, stimulation testing is performed.
  5. Radiofrequency is applied for approximately 60 seconds per site.
  6. The procedure lasts around 30–40 minutes.

 

“Dr. Gilete made me feel safe in Barcelona from the moment we met in person in our consultation, right through the operating stage and the final moment of discharge from Hospital.”

In selected cases, sedation is offered for increased comfort. Our team also implements Opioid-Free Anesthesia (OFA) protocols when needed, especially in patients with multiple sensitivities.

 

Recovery and Expected Results

Rhizolysis is an outpatient procedure. Patients are observed briefly and discharged the same day. Recovery is typically smooth:

  • Light rest is recommended the first 48 hours.
  • Some localized soreness is normal and short-lived.
  • Full effect may take 2–3 weeks to appear.
  • Relief lasts from 6 months to 2 years, depending on nerve regeneration.

 

According to literature and our experience:

  • ~50% of patients achieve significant relief (lasting >6 months).
  • ~25% report partial improvement.
  • A minority do not respond.

 

“From the moment I became their patient they were very caring and respectful. […] I’m now slowly getting my life back from being mostly bed bound for several years. The pain is minimal and all previous symptoms caused by the instability are gone.”

In the event of pain recurrence, the procedure can be repeated, or alternative strategies can be evaluated.

Surgeon wearing a green surgical cap, mask, and blue gown using a radiofrequency needle on a patient draped in green cloth under a C-arm intraoperative radiology machine
Gloved hands holding a radiofrequency needle connected via a blue cable to a radiofrequency generator on a green surgical drape
Intraoperative image showing sensory nerve stimulation with electrodes applied to assess neural response.

Risks and Safety Considerations

Rhizolysis is a low-risk procedure. However, as with any intervention, there are rare potential side effects:

  • Bleeding or hematoma at the puncture site
  • Temporary numbness
  • Pain flare post-procedure (resolves with analgesia)
  • Allergic reaction to local anesthesia
  • Infection (rare with sterile protocol)

 

Patients on antiplatelet or anticoagulant therapy must inform the team in advance.

“As an instructor in minimally-invasive spinal surgery, Dr. Gilete teaches other surgeons techniques with less blood loss, reduced risk of muscle damage, and reduced risk of infection.”

 

Why Choose Our Center for Rhizolysis?

At DrGilete.com, rhizolysis is not a stand-alone option. It’s integrated into a comprehensive pain evaluation, alongside:

  • Imaging (MRI / CBCT)
  • Facet block diagnostics
  • Inflammatory and immunological screening
  • Surgical or regenerative options when needed

 

We specialize in complex spinal pain—especially in patients with connective tissue disorders like Ehlers-Danlos Syndrome—offering precise, humanized and multidisciplinary care.

 

Frequently Asked Questions

 

Is rhizolysis the same as rhizotomy?

They are closely related. Rhizolysis usually refers to radiofrequency ablation of facet joint nerves. Rhizotomy usually refers to section of facet joint nerves..

How long does it last?

Pain relief varies: 6 months to 2 years is common, though some patients report shorter or longer durations depending on regeneration.

Will it completely eliminate my pain?

While many feel substantial relief, not all pain originates from the facet joints. It may reduce the component related to joint inflammation.

Can it be repeated?

Yes, the procedure can be safely repeated if the pain returns and the source remains the same.

What if it doesn’t work for me?

Other strategies such as neuromodulation, regenerative therapy, or surgical evaluation may be considered depending on your case.

 

Final Thoughts

Rhizolysis offers an effective and safe alternative for patients with chronic spinal pain, especially when conservative treatments have failed. Our extensive experience, modern imaging, and patient-centered approach make Dr. Gilete and the Promohealth team a trusted partner in your journey to recovery.

If you’re experiencing chronic spinal pain and wondering if rhizolysis could help you, book a consultation with our medical team today. Imaging can be performed in Barcelona, and we offer both in-person and remote evaluations.

 

 

Reviewed and approved by Dr. Vicenç Gilete, MD, Neurosurgeon  & Spine Surgeon | May 20, 2025

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