Radiofrequency Ablation/Rhizotomy

What is a RFA/Rhizotomy?

A rhizotomy is a procedure that is used to prevent sensory nerves from sending pain messages to the brain by heating the nerve with a radio wave.


How does it work?

When the spine is injured, diseased, degenerated, or surgically treated, the facet joints may be affected. These joints frequently become arthritic and painful.  The resulting symptoms in the low back are typically back pain which radiates into the legs to just above the knee. Pain and stiffness of the lower back is also noted and leaning forward slightly may make the pain better. In the upper spine, the experience is pain and stiffness. This treatment is used to relieve the pain that is produced by inflammation of the facet joint. This procedure can also be used to relieve pain in the sacroiliac joint.


How is it performed?

A RFA/Rhizotomy is performed in the procedure room using fluoroscopy (x-ray). Sedation may or may not be used for this procedure. The patient is positioned on the fluoroscopy table and the joints to be treated are identified. The skin is then frozen and a numbing medication (local anesthetic) is injected around the joints to be treated.  A small wire is then inserted into a needle adjacent to the joint nerve. With the wire in the proper position a radiofrequency wave is applied which heats the tissue and destroys the joint nerve.


What are the potential risks with a RFA/Rhizotomy?

As with any invasive procedure, there is the risk of infection and bleeding at the injection site. Very rarely nerve damage can occur.


What are the expected benefits of this treatment?

Pain relief is usually delayed after a RFA/Rhizotomy. It may take up to 4 weeks to fully evaluate the benefit of the procedure. In some cases, the pain may be worse for the first 1-2 weeks following the procedure. Generally, ice applied to this area is helpful. This procedure is most effective when combined with other methods to control pain which include physical therapy, medication management, weight loss, smoking cessation, and other recommended interventions.