Free Pain Screening Quiz
Pain presents itself in many different ways, at different times and in many cases is triggered by specific activities.
Arizona Pain Treatment Centers will be happy to answer your questions in conjunction with a personal phone call follow up with one of our doctors.
Please answer the questions as accurately as possible.
Endoscopic rhizotomy surgery is an outpatient surgery.
The surgery is done under conscious sedation. A small (7mm) incision is made in the surgical area and a tube with a camera is inserted into the spine, guided by fluoroscopic X-ray to place the camera in the correct position.
The camera allows for direct visualization to see the inside of the spine where the medial branch nerves usually reside. After identifying the nerve, a small section is cut from the nerve, preventing any regrowth in the future.
The camera is removed and the incision is closed with a single absorbable suture that is buried under the skin, so that no suture removal is needed. The procedure takes about 45 minutes to complete but may take longer depending on the number of nerves required to be treated.
• Lower back pain longer than 6 weeks with no response to conservative treatments
• Palpation of the facet joints causes muscle spasm and deep tenderness
• Restricted range of movement in the lumbar spine or low back, particularly when bending backwards
What is a minimally invasive endoscopic rhizotomy surgery?
Rhizotomy video provided by Joimax
An endoscopic rhizotomy is a minimally invasive endoscopic surgery that allows direct visualization of the medial branch nerves that supplies the facet joints in the back of the spine. This procedure may also be called a facet joint denervation.
Medial branch nerves are very small nerves that innervate the facet joints of the spine. Facet joints are the joints connecting the different vertebra of the spine to each other. The joints are present on both sides of the spine from the neck to the lower back.
The surgery takes the percutaneous radiofrequency ablation procedure (RFA), a common procedure where we use special needles and electrical current to turn off the nerves, an important step further by providing direct endoscopic visualization of the posterior spinal anatomy and nerves.
Different between a radiofrequency ablation and a rhizotomy
“A radiofrequency ablation is a procedure for back pain where we use special needles and electrical current to turn off the nerves and their ability to transmit pain signals. We get an average of 11 months of relief. By that time, the nerve may heal and the pain may return.
The surgical aspect of a rhizotomy is a little more invasive, but still considered an endoscopic minimally invasive surgery or procedure. The incision is smaller than a centimeter and involves the use of a camera through which we can use special tools to identify the nerves, and surgically remove those nerves, and then perform an ablative procedure under direct visualization.”
The result of a rhizotomy is a little more invasive than a RFA but is still considered an endoscopic minimally invasive surgery or procedure. The incision is smaller than a centimeter and involves the use of a camera through which we can use special tools to clearly identify the nerves, and surgically remove those nerves, and then perform an ablative procedure under direct visualization. The incision site is closed with one or two stitches and a small bandage.
What are some of the advantages of a rhizotomy surgery?
• Minimally invasive procedure
• Small incision and minimal scar tissue
• Outpatient procedure
• Short recovery time
• High success rate and sustained success of the therapy
• No or minimal blood loss
• Possible use of local anesthesia
• Spinal mobility is maintained
• Visual endoscopic control of the treatment
When is rhizotomy recommended?
• Patient has lower back pain longer than 6 weeks with no response to conservative treatments
• Palpation of the facet joints causes muscle spasm and deep tenderness
• Patient has restricted range of movement in the lumbar spine, particularly when bending backwards
• Blocking the facet joint or medial branch nerve confirms that lower back pain is caused by the facet joint
What are the indications for a rhizotomy?
A rhizotomy is indicated if the diagnostic *medial branch block (MBB) procedure is successful in confirming back pain is originating from the facet joints. For the sacroiliac joint, a successful sacroiliac joint injection is needed.
*Medical branch block (MBB) is an injection of a local anesthetic directly near the medial branch nerve to temporarily block the pain signal carried from the facet joints to the brain. It is a diagnostic tool and provides only temporary relief from pain and is used in diagnosing the cause of your back pain.
After the medial branch block(MBB) your pain may:
• Go away for a few hours
• A few days or
• Not reduce at all
If the pain is relieved after the medial branch block, this indicates that the origin of the pain is the medial branch nerves that were numbed. Our team may recommend a radiofrequency ablation (RFA) or proceed to an endoscopic rhizotomy.
As a multi-disciplinary team, we understand that pain can change and destroy a person’s life. It is discouraging to watch our patients, friends and family suffer in pain. We know we can make a difference and help provide the best education and options available. We offer Endoscopic Microdiscectomy and Endoscopic Rhizotomy procedures. Our non-surgical treatments offered are therapeutic and diagnostic injection medicine therapy. These include epidural steroid injections, non-steroidal injections, nerve blocks and ablations, joint injections, and trigger point injections. We also offer many other procedures for pain relief.
We are passionate about giving life back to our community every day. We specialize in most types of pain, including neck and back pain, arm and shoulder pain, leg, hip and knee pain, as well as headaches and migraines. We treat pain from Car Accident or Wreck Injuries, Sport Injuries, Workman’s Comp and daily wear and tear.
We are excited to be known by our patients and referring Primary Care Physicians as Top Doctors and Top Pain Specialists in Phoenix. We are also proud to have great relationships with other pain centers like Arizona Pain Specialists, The Pain Centers of Arizona, Arizona Pain Centers, Advanced Pain Management, Sonoran Spine and Barrow Neurosurgical Institute.
Arizona Pain Treatment Centers has been serving the greater Phoenix area since 1997. We have patients under our care that live in Phoenix, North Phoenix, Scottsdale, Peoria, Glendale, Maryvale, Tolleson, South Phoenix, Mesa, East Mesa, Tempe, Chandler, Ahwatukee, Gilbert, Queen Creek, San Tan Valley, Apache Junction, Tuscon, and even Globe.
We are commitment to making a difference and being the difference in all of our patient’s lives and their family and friends lives. Thank you!