Radiofrequency Thermal Coagulation-Rhizotomy
What Is a Rhizotomy?
It is a procedure in which a radioquency device is used to coagulate the median branch nerve of the facets (Cervical, Lumbar, Thoracic). The lesion is created, by heating the nerve to 80 degrees Centigrade for approximately 80-90 seconds.
Who Is a Candidate for a Rhizotomy?
Patients that have facet pain previously diagnosed by facet injection, resulting in excellent, but short lasting relief. The purpose of the median branch rhizotomy is to create long lasting relief, so that improve function and rehabilitation can be accomplished.
The procedure can be performed as an outpatient, in the office, hospital or out patient surgical facility. Usually the procedure is performed under local anesthetic with intravenous sedation, in order to facilitate relaxation and assist in comfort. This decision will be made based on individual preference and medical necessity. Oral medications are also available to assist with relaxation before and during the procedure. You will be taken to the procedure suite, place in the fluoroscopy bed lying on your stomach. Blood pressure and cardiac monitors will be applied.
Next, the skin overlying the facets area is cleansed with a sterile solution. Then a solution of local anesthetic (numbing medication) is infiltrated in the skin and deeper tissues overlying the respective facet joints median nerve. Under fluoroscopic guidance (X-ray machine), a special needle is inserted in the facet nerve and coagulated with the radiofrequency device. The procedure usually takes 30 minutes.
After the Procedure
You will go back to the post anesthesia care unit (if you received intravenous sedation), where you will be monitored for 30-60 minutes according to your response. If no sedation was used, according to your specific condition, you may proceed to the post procedure observation area. Immediately after the procedure, you will be evaluated to assess for specific response. Post procedure instructions will be given in a pre-printed form. It can take as long as three weeks before the full benefit from the Rhizotomy can be noticed. It is not advisable that you drive the day of the procedure.
General Pre and Post Procedure Instructions
If no intravenous sedation is planned, you continue with your usual dietary habits the day of the procedure. If intravenous sedation is planned, avoid eating any king of solid foods prior to the procedure and you may have clear liquids up to 4 hours prior to the procedure. If you are taking Coumadin, Heparin, Plavix or non-steroidal anti-inflamatories (such as aspirin, ketoprofen, naproxen or others), stop taking them at least one week prior to the procedure. If you are diabetic and planning on having IV sedation, our office will give you specific instructions. The decision to return to work after the procedure will be made on an individual basis considering medical necessity and your specific condition.