If you suffer from pain that does not respond to conventional medical therapies, it could be time to explore rhizotomy. Rhizotomy is a pain management technique performed at the LAMIS (Los Angeles Minimally Invasive Spine) Institute that has helped many patients manage their pain and enhance their overall quality of life. This minimally invasive technique can relieve your symptoms for several years. You can call our Los Angeles practice to make an appointment and find out how this procedure can assist you in getting back to your active lifestyle.
What is Rhizotomy?
Rhizotomy is a surgical procedure used to get rid of sensation from a sore nerve by eliminating nerve fibers essential for delivering pain impulses to your brain. A surgical tool can be used to cut nerve fibers, and they can also be burned chemically or using an electrical current. Rhizotomy typically results in instant pain alleviation that lasts several years till the nerve heals and can once again transmit pain signals. Rhizotomy, also known as neurotomy or ablation, is the process of removing or deadening tissues.
The Purpose of a Rhizotomy Procedure
A rhizotomy procedure is typically performed to improve a patient's overall quality of life by reducing neck and back pain. This procedure helps patients resume their regular activities while restoring movement and reducing pain in a safe, efficient, as well as minimally invasive manner. A rhizotomy procedure can provide necessary relief from nerve pain, which can be severe at times.
A rhizotomy surgeon can begin the surgery by overseeing the insertion of an electrode through fluoroscopy. After inserting the needle, a little electrical current activates the painful nerve to determine the precise location. The sensory nerves are then deadened by heating the electrode, which prevents pain messages from reaching the brain.
A rhizotomy procedure is among the most minor invasive treatments available to address back and neck pain. However, it's only going to be provided as an option when conservative therapies have not succeeded in providing relief to patients with severe facet joint problems such as facet syndrome. When a patient's back pain is isolated to one area or location in the spinal column and they don't have any other symptoms, they can benefit from a rhizotomy surgery.
Medical Conditions That can be Treated Using a Rhizotomy Procedure
Rhizotomy could be performed to treat a variety of painful conditions and unusual nerve activity, including:
- Neck and back pain brought on by spinal stenosis, arthritis, herniated discs, as well as other progressive spine disorders. Facet rhizotomy, a technique used to treat these problems, involves cutting the nerves that pass through the spine's facet joints
- Trigeminal neuralgia is a type of facial pain brought on by trigeminal nerve irritation.
- Arthritis-related joint pain that can be felt in the knee and hip
- Other disorders that affect the peripheral nervous system
- Spasticity is unusual spasms and muscle tightness. A selective dorsal rhizotomy is a surgery that can assist the muscles and spine communicate better in people with cerebral palsy spasticity
Types of Rhizotomy
Rhizotomy can take several different forms, but they all require severing the nerve fibers that deliver pain signals. Rhizotomies could be carried out under local or general anesthesia, based on where the nerve is located, and are frequently guided by X-ray, fluoroscopy, as well as alternative image-guided methods to assure accuracy.
In this kind of rhizotomy, the damaged nerve root is treated with a little amount of a substance (such as glycerol or glycerin). This substance destroys the symptoms in the nerve fibers between forty-five to sixty minutes.
A radiofrequency rhizotomy (sometimes called a radiofrequency ablation procedure) is comparable to glycerol rhizotomy, except instead of employing a substance to damage the fibers, a radiofrequency signal is utilized to destroy the nerve fibers. It is frequently used on individuals who don't fully benefit from glycerol or who experience repeated pain or might require help breaking through scar tissues.
During endoscopic rhizotomy, the afflicted nerve is located and the fibers are severed using a camera tool known as an endoscope. A tubular retractor technique, which consists of several tubings, is used to implant the endoscope using a tiny incision. As a result, healthy tissues and organs can be avoided and your surgeon can reach the nerve. Another name for this process is directly visualized rhizotomy.
Getting Ready For Rhizotomy
To verify the primary diagnosis and ensure that the therapy will be beneficial for you, your physician will request that you take part in several tests.
An MRI test could be necessary, for instance, if you have spinal pain or trigeminal neuralgia. If you suffer from a phobia of tight places, being put inside a small tube for the MRI could leave you feeling claustrophobic at times. Fewer facilities do provide open MRI scanners, but the photos might be less clear. It is suggested to request earplugs to assist in blocking out the loud noises made by the MRI scanner.
Before the surgery, you will also need to take a few standard tests, including:
- Blood tests such as tests to determine your blood group and hemoglobin levels
- Electrocardiogram to ensure that the heart is in good shape
- A chest x-ray
- Urine tests
- An extensive evaluation of the heart could be necessary for older patients
What Takes Place During this Procedure?
The following happens during this procedure:
The majority of rhizotomy procedures include general anesthesia. During this procedure, you'll be sleeping and won't be awake to see what's happening. You will receive an intravenous sedative if you have a rhizotomy performed utilizing substances like glycerin injection.
The above-mentioned routine examinations are requested just several days before the procedure. Admission could be necessary the day preceding surgery. You will be instructed to cease using aspirin and other blood thinners several days before the surgery.
Fasting Before Your Surgery
It is necessary to fast overnight, and sometimes intravenous fluids could be needed to help you stay hydrated. Sedation might also be necessary for a good night's sleep.
Change Locations from the Room or Ward to the Operating Room's Waiting Area
You'll be brought on a trolley to the operating waiting room one or two hours before the procedure. You'll be transferred to the operation room once it has been prepared.
Proceed to the Operation Room
A little sedation could help you get over your fear because the operation room setting can be a little intimidating. You will be transferred from the trolley to the operation table. When you look up, you'll notice the operation light station and the anesthetic unit at the head end. There could be devices to assess the ECG, oxygen levels, and other vital signs. The monitors could beep continuously, which could sometimes be annoying.
Anesthesia Before the Surgical Procedure
To induce deep sleep, an anesthesiologist will administer medications intravenously while forcing you to breathe in gas using a mask. When you are unconscious, a tube will then be put inside your mouth as well as your windpipe to provide anesthetic gases that will help you stay numb to any pain.
During the Operation
The majority of rhizotomy treatments involve general anesthesia, while others, such as facet rhizotomy, could be carried out under local anesthetic. The nerve fibers that need to be removed are located using an imaging method known as fluoroscopy, which also serves to direct the tools to the right positions.
You'll then be placed based on the kind of procedure you will have. For instance, you might be forced to rest on your belly with padding over your bony areas if you suffer from a lower back condition. You will remain seated throughout the trigeminal neuralgia glycerol injection process.
For treating trigeminal neuralgia, surgical instruments are commonly introduced through the cheeks and stretched to the source of the trigeminal nerves using the incision at the bottom of the skull.
What Happens After the Rhizotomy Procedure?
If you were given general anesthesia, you'll wake up after the procedure and the tubing down your windpipe will be extracted. Before the tubing is taken out, you will be requested to have your eyes open. You'll be anesthetized, and your anesthetist's voice would sound faint. You can experience nausea as well as a cough after the tubing is removed.
A nasogastric tube, also known as a Ryle's tube, could well be inserted inside your stomach to help in keeping it empty. Additionally, there's going to be an IV line. You'll also continue to receive oxygen. You will then be placed on a trolley and transferred to the recovery area when you are completely awake.
Before moving you to a ward or room, a nurse will keep an eye on your vitals and keep you under observation in a recovery room for one hour or even two.
You could have brief numbness in the area served by the destroyed nerves. You might be released on that day or maybe the following. Your physician will advise that you go to the facility for any follow-up appointments.
Side Effects and Risks of Rhizotomy
Rhizotomy risks vary depending on the kind of treatment as well as the nerves being operated on.
Risks associated with glycerol or glycerin rhizotomy include infection, nausea, bleeding, vomiting, as well as a slight likelihood of sensory alteration (a numbing sensation). Compared to the chemical technique, radiofrequency rhizotomy is more likely to result in sensory changes (such as numbing sensations).
Benefits of a Rhizotomy Procedure
The following are benefits associated with rhizotomy:
Rhizotomy can Help Relieve Pain
Rhizotomy is a surgical treatment that can treat degenerative disc degeneration, spinal stenosis, as well as facet joint dysfunction to alleviate chronic pain. To prevent pain impulses from reaching the brain, this treatment involves severing nerve roots. Rhizotomy can significantly reduce pain symptoms for a large number of patients and enhance the quality of their lives.
Your Flexibility and Motion Range can Both be Enhanced through Rhizotomy
Rhizotomy is a surgery that can increase your flexibility and range of motion. The spinal cord is the most typical location for this operation, though it can be conducted on any joints within the body. Rhizotomy can assist in reducing pain and enhancing your capacity to move the afflicted joint by severing the nerve fiber roots that attach to it. Your mobility, as well as your standard of living, can be improved with rhizotomy treatment, which is secure and reliable.
Spasticity in the Muscles can be Reduced through Rhizotomy
Muscle spasms may also be reduced using this surgical treatment. This procedure entails severing the nerve fiber root that delivers nerve impulses to the muscle. It can lessen muscle spasms by cutting off the signals that cause them. Rhizotomy is typically only taken into consideration after exhausting all other curative alternatives. The technique is often used as a last option.
Rhizotomy is a Safe, Efficient, and Minimally Invasive Procedure
Rhizotomy can be described as a minimally invasive treatment that is both safe and efficient. The procedure entails severing or destroying the painful nerve roots. This can ease the discomfort brought on by disorders including facet joint arthritis, spinal stenosis, or ruptured discs.
Rhizotomy could be carried out as a component of a bigger procedure. like spinal surgery. or it could be carried out independently.
What is the Rhizotomy Success Rate?
Rhizotomy, like many medical interventions, cannot guarantee a 100 percent success rate. Some people who have the procedure will experience minimal to no pain alleviation, whereas, for others, their pain could come back as the nerve regenerates in the subsequent years. However, such cases make up a relatively minor portion of all cases. A rhizotomy specialist can provide you with all the knowledge you require to reach an informed decision about the procedure. The large majority of people who receive rhizotomy surgery get long-lasting pain alleviation.
Find a Rhizotomy Specialist Near Me
If you have exhausted all conservative therapies for severe spinal and joint pain without success, you should talk to your physician about a rhizotomy procedure. The rhizotomy procedure has been effective in alleviating chronic pain for our patients at the LAMIS (Los Angeles Minimally Invasive Spine) Institute. Contact our Los Angeles practice today at 310-734-6088 to schedule a consultation with one of our specialists.