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Radio Frequency Lesioning or Facet Rhizotomy

Most patients suffering from back and neck pain receive help in the form of a mixture of physical therapy, medication, and spinal injections in specific areas. However, patients sometimes experience pain despite these procedures. In these cases, other types of procedures can be helpful in reducing pain for these types of patients.

Facet rhizotomy or radio frequency lesioning is a medical procedure used to interrupt nerve signals temporarily. The procedure normally blocks nerve conduction for up to 9 months. It is an outpatient procedure for treating pain arising from the joints of the spine, often performed at a laser spine clinic.

The doctor begins by identifying the specific nerve that is transmitting pain signals to the brain. A nerve block test numbs certain nerves to help the doctor locate the nerves causing the pain.

The Procedure

The procedure itself heats an area of nerve tissue, interrupting nerve pain signals in that area. This has the effect of reducing pain in this location.

Sometimes, patients first have X-rays taken to identify a target for the radio-frequency probe. After receiving a local anesthetic, the patient has an instrument placed under their skin. The tissue is heated when electricity is passed through the instrument to produce heat. This results in a "stunning" of the nerves and blocks them from transmitting pain signals to the brain.

A rhizotomy procedure is conducted in an operating room, normally taking anywhere from 30 minutes to one hour to complete. Times can vary, depending upon the number and location of the nerves requiring blocks. If a nerve that does not cause pain is blocked, it will not result in reduction of pain for the patient.

Procedure Benefits

There are a number of advantages to undergoing a facet rhizotomy. The procedure is minimally invasive and can be conducted on an outpatient basis. The rate of success is high, and recovery times tend to be short. There is very little blood loss, and only a small incision is necessary. There is only minimal scar tissue formation as a result. Also, anesthesia is local.

This is generally considered to be a safe procedure. There are some small risks, like infection, allergic reactions to anesthetics, and minimal bleeding. Nerve damage may also occur, although this is quite rare.


Patients generally recover quickly following the procedure. Some report minimal discomfort at instrument placement sites. This discomfort typically diminishes over a few days. Occasionally, nerve tissue that has been blocked will regenerate, requiring a follow up procedure.


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