Endoscopic rhizotomy is a minimally invasive endoscopic surgery that allows direct visualization of the medial branch nerve that supplies the facet joints in the back of the spine. The operation takes the percutaneous RF facet denervation procedure an critical step further by providing direct endoscopic visualization of the posterior spinal anatomy and nerves. A quarter-of-an-inch incision is made, and a camera is inserted in the spine. By cutting a section of the medial branch nerve, the pain signal is interrupted.
Radiofrequency rhizotomy is indicated if a diagnostic procedure called medial branch block is successful in confirming the patient’s back pain is originating from the facet joints. For the sacroiliac joint, a successful sacroiliac joint injection is needed. Medial branch block 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. It is used to assist your physician in diagnosing the cause of your back pain.
Endoscopic rhizotomy is outpatient surgery. The surgery is done under deep sedation, and there is no pain during the operation. A small (7mm) incision is made in the surgical area, and a tube with a camera is inserted into the spine. The doctor is guided by fluoroscopic X-ray to place the camera in the correct position. The camera allows the surgeon to see the inside of the spine where the nerve usually resides. The surgeons use a microscopic cauterizing instrument to find the small nerve branches that supply the joints in the spine. After identifying the nerve, a small section is cut from the nerve, preventing any regrowth in the future.
Some complications may include:
- Allergic reaction.
- Increased pain.
- Non-immediate pain relief.