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Rhizotomy is a minimally invasive procedure used to relieve chronic nerve-related pain by targeting and disrupting specific pain-carrying nerve fibres. It is often recommended for patients with conditions such as trigeminal neuralgia, facet joint pain, sciatica, or spasticity that do not respond well to medications or physical therapy.
The procedure works by interrupting the nerve's ability to send pain signals to the brain, providing lasting relief and reducing dependence on painkillers. Rhizotomy can be performed using various techniques, including radiofrequency ablation, where heat is used to destroy the nerve, or chemical methods involving targeted injections. In some cases, especially for severe muscle stiffness, open surgical rhizotomy may be used.
The procedure is typically done under local or general anaesthesia, depending on the technique and patient condition, and is often completed as a same-day surgery with minimal hospital stay. It aims to improve quality of life by reducing pain and restoring function, although the results may vary based on the underlying condition and the patient’s overall health.
Rhizotomy is a procedure performed to relieve chronic nerve-related pain or muscle spasticity by disrupting pain signals travelling through specific nerve roots. It is commonly used to treat conditions such as trigeminal neuralgia, spasticity from cerebral palsy or multiple sclerosis, and facet joint pain in the spine (radiofrequency rhizotomy). The goal is to reduce or eliminate pain or involuntary muscle movements by selectively targeting the nerves causing the problem, while preserving other functions.
You should consult a specialist if you experience:
- Severe, chronic nerve pain that doesn’t respond to medication
- Sharp, stabbing facial pain (in trigeminal neuralgia)
- Muscle tightness or spasms due to neurological disorders
- Persistent back or neck pain due to facet joint inflammation
- Limited quality of life despite physical therapy or injections
Preparation depends on the type of rhizotomy, but generally includes:
- Neurological and physical exam
- Imaging studies such as MRI, CT scan, or fluoroscopy
- Diagnostic nerve blocks may be done beforehand to confirm the pain source
- Review of current medications, particularly blood thinners
- Fasting for 6–8 hours before the procedure (if under sedation or anaesthesia)
- Discussion of risks, benefits, and expected outcomes with your doctor
There are several types of rhizotomy, depending on the condition:
- Radiofrequency Rhizotomy: A needle is guided to the nerve using imaging, and heat is applied via radiofrequency waves to destroy the pain fibres.
- Chemical Rhizotomy: An alcohol or glycerol injection is used to damage the nerve fibres selectively.
- Surgical Rhizotomy: A neurosurgeon cuts the problematic nerve root through a small incision, often used for spasticity in children or facial nerve pain.
- Balloon Compression (in trigeminal neuralgia): A balloon compresses the nerve to disrupt pain signals.
Rhizotomy typically takes 30 minutes to 2 hours, depending on the method used. Most patients go home the same day, except in cases of open surgical rhizotomy, which may require a short hospital stay.
While generally safe, potential risks include:
- Temporary numbness or weakness
- Pain recurrence over time
- Infection
- Bleeding
- Nerve damage
- Facial drooping (in facial rhizotomy)
- Cerebrospinal fluid leak (in open procedures)
- Significant and targeted pain relief
- Minimally invasive, with quick recovery in most cases
- May delay or avoid more invasive surgery
- Improved daily function and quality of life
- Often reduces or eliminates the need for long-term medications
Recovery is usually quick, especially with outpatient procedures. Patients may experience temporary soreness, numbness, or mild weakness. Light activities can typically resume in 1–2 days, while full recovery depends on the technique used. Pain relief may be immediate or gradual over a few days. Follow-up is essential to monitor outcomes and determine if repeat treatment is needed in the future.
Rhizotomy has a high success rate, with 70–90% of patients reporting pain relief or reduction in symptoms, depending on the condition treated. In trigeminal neuralgia, radiofrequency rhizotomy can provide effective relief lasting 1–5 years, though retreatment may be needed if symptoms return.
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+99Process Involved for Rhizotomy
- Evaluation Stage: The doctor reviews the patient’s symptoms and medical history and performs physical and neurological examinations.
- Imaging and Diagnostic Tests: Imaging techniques, such as MRI, CT scans, or X-rays, help locate the irritated nerve and determine the exact origin of the pain.
- Diagnostic Nerve Block: A temporary nerve block helps verify if the targeted nerve is responsible for the pain.
- Preoperative Preparation: The patient receives instructions on fasting, medication adjustments, and safety precautions to ensure a smooth surgical experience.
- Procedure Stage: The nerve is treated using radiofrequency ablation or surgical methods under imaging guidance.
- Post-Procedure Monitoring: The patient is observed briefly to monitor for side effects and assess the level of pain relief.
- Recovery and Follow-Up: Regular follow-ups are done to evaluate healing and long-term effectiveness.
- Trigeminal Neuralgia: Sharp facial pain caused by irritation of the trigeminal nerve.
- Facet Joint Pain: Chronic back or neck pain originating from spinal facet joints.
- Sciatica: Radiating leg pain due to pressure or irritation on the sciatic nerve.
- Spinal Stenosis: Narrowing of the spinal canals causes nerve compression and pain.
- Herniated Disc: Bulging spinal discs pressing on nerves, leading to back and limb pain.
- Arthritic Spine: Degenerative changes in spinal joints that cause persistent pain.
- Sacroiliac Joint Pain: Pain in the lower back and pelvis linked to sacroiliac joint dysfunction.
- Chronic Neck Pain: Long-term neck pain is often linked to nerve or joint issues.
- Post-Surgical Pain: Persistent pain following spine or nerve surgeries.
- Neuropathic Pain: Pain from damaged or irritated nerves unresponsive to medication.
- Patient Evaluation: The doctor assesses the patient's pain condition, medical history, and suitability for the procedure.
- Imaging Guidance: MRI, CT, or X-ray scans are used to accurately locate the nerve causing the pain.
- Anesthesia Administration
Local or general anaesthesia is given based on the method and site of the procedure. - Needle or Electrode Insertion: A thin needle or probe is carefully placed near the target nerve using real-time imaging.
- Nerve Confirmation: Mild electrical stimulation may be applied to ensure the correct nerve is being treated.
- Nerve Disruption: The nerve is disabled using radiofrequency, heat, or surgical cutting to block pain signals.
- Post-Procedure Monitoring: The patient is monitored for a short period to check for complications and assess early pain relief.
- Discectomy
- Laminectomy
- Foraminotomy
- Neurotomy
- Ablation
- NerveBlock
- Spinal Fusion
- Facet Rhizotomy
- Electrocoagulation
- Radiofrequency
- Pain Relief: Helps manage long-term nerve-related pain by turning off the affected nerve.
- Less Invasive: Uses small instruments or needles, leading to fewer complications.
- Faster Healing: Patients often recover quickly and return to their daily routines sooner.
- Better Movement: Reduces discomfort, allowing smoother physical activity.
- Lower Drug Dependence: This may decrease the need for regular pain medications.
- Precise Action: Specifically targets the problematic nerve without affecting others.
- Can Be Repeated: The treatment can be safely performed again if the pain returns over time.
- No Hospital Stay: Typically done as a same-day outpatient treatment.
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