TREATMENT OVERVIEW

Endoscopic Rhizotomy

Endoscopic Rhizotomy is an advanced, ultra-minimally invasive procedure designed to provide long-lasting relief from chronic back and neck pain. By using a high-definition camera (endoscope), this technique allows your doctor to directly visualize and precisely deactivate the specific sensory nerves that are transmitting pain signals from arthritic facet joints, offering significant pain relief without the need for fusion or major surgery.

Medical illustration showing facet joints on the spine, the target for an endoscopic rhizotomy
Patient undergoing a fluoroscopy-guided injection for pain management

Quick Facts

  • • Procedure Duration: 30-60 minutes
  • • Anesthesia: Local with sedation (conscious sedation)
  • • Pain Relief Onset: Can be immediate, or take 2-3 weeks
  • • Relief Duration: 6 months to 2+ years

PROCEDURE DETAILS

What Happens During an Endoscopic Rhizotomy?

After you are given IV sedation to ensure you are comfortable, a very small incision (less than 1 cm) is made over the target area. A thin tube called an endoscope, which has a camera, light, and working channel, is guided to the painful nerve.

Unlike traditional 'blind' rhizotomy, the endoscope provides a direct, high-definition view of the nerve. This allows your doctor to confirm the exact nerve causing your pain and avoid surrounding tissue.

A specialized radiofrequency (RF) probe is passed through the endoscope. Your doctor will test the nerve to confirm it's the right one (you may feel a familiar sensation). Then, thermal energy is applied to create a lesion, deactivating the nerve and stopping the pain signals.

TREATMENT ADVANTAGES

Benefits of an Endoscopic Approach

The endoscopic approach transforms rhizotomy from a 'blind' procedure to a precise, visualized one, offering significant advantages for treating chronic facet joint pain.

Unmatched Precision

The endoscope's camera allows for direct visualization of the nerve, ensuring the correct target is treated, which is not possible with traditional techniques.

Long-Lasting Relief

By deactivating the pain-sending nerve, a successful rhizotomy can provide pain relief that lasts from 6 months to several years.

Ultra-Minimally Invasive

The incision is tiny (often just one stitch), leading to almost no scarring and minimal tissue disruption.

Rapid Recovery

Most patients go home the same day and can resume normal activities within a few days.

Preserves Spinal Stability

The procedure does not cut muscle and does not require implants or fusion, preserving the natural structure of your spine.

High Success Rate

Direct visualization increases the likelihood of a successful ablation and significant, lasting pain reduction.

IMPORTANT INFORMATION

What are the Risks?

Endoscopic rhizotomy is a very safe procedure, especially with endoscopic guidance. Risks are rare but are important to understand.

Common Side Effects

  • Temporary soreness or bruising at the incision site
  • A temporary feeling of numbness or "sunburn" over the treated area
  • Post-procedure muscle stiffness, which resolves in a few days
  • Temporary increase in nerve pain (neuritis), which is uncommon

Rare Complications

  • Infection at the incision site
  • Incomplete pain relief
  • Damage to a nearby motor nerve (endoscopic view makes this very rare)
  • Nerve pain (neuritis) that lasts for several weeks

Important: This procedure is not a 'cure' for arthritis, but a way to 'turn off' the pain it causes. The nerve can eventually grow back, but the procedure can be repeated if pain returns.

PREPARATION GUIDE

How to Prepare for the Procedure?

Preparation is simple and focused on ensuring your safety and comfort during the procedure.

Diagnostic Blocks

You must have had successful diagnostic nerve blocks (e.g., medial branch blocks) to confirm you are a candidate.

Medication Adjustments

You must stop blood thinners (Aspirin, Plavix) and NSAIDs as instructed by your doctor, typically 5-7 days before.

Fasting & Transportation

Do not eat or drink after midnight. You must have a responsible adult drive you home due to the sedation.

Day of Procedure

Wear loose, comfortable clothing. You will change into a gown for the procedure.

RECOVERY GUIDE

The Endoscopic Rhizotomy Recovery

Recovery is typically very quick. Most of the recovery is just letting the small incision heal and the nerve 'quiet down'.

Post-Op Area (1-2 Hours)

After the ~1-hour procedure, you'll be monitored as the sedation wears off. You will go home the same day.

First 2-3 Days

You will have soreness at the small incision site, easily managed with ice and over-the-counter pain relievers. You can walk and do light activities.

Weeks 1-3

This is the key period. Some patients feel relief immediately. Others may experience a temporary increase in nerve pain (neuritis) before the full, lasting relief sets in.

1 Month & Beyond

The full benefits are typically felt by 2-3 weeks. You can resume all normal activities, including physical therapy, to strengthen your core and supporting muscles.

When to Contact Your Doctor

  • Signs of infection (fever, chills, redness/drainage)
  • Severe, unrelenting pain not helped by medication
  • New or worsening weakness in your legs
  • Loss of bowel or bladder control (very rare)

Ready to Get Started?

Please don't hesitate to reach out and request an appointment. We look forward to meeting with you, addressing your concerns, and working together to enhance your quality of life.

Call Now Book Appointment