Many struggling with chronic neck or lower back pain seek one thing: relief from the pain. This is precisely what can be achieved with endoscopic facet rhizotomy, a minimally invasive spine surgery used to deaden pain-causing nerves, according to interventional pain management specialist Kaliq Chang, MD, with Atlantic Spine Center.
According to Dr. Chang, “facet joints are often a primary source of pain because they are almost constantly in motion as we move about and can break down as we age and from repetitive injury.”
“Since facet joint pain is one of the most common causes of back pain, endoscopic facet rhizotomy surgery has become more and more popular and useful,” says Dr. Chang. “Our patients often feel better very quickly after facet rhizotomy surgery and report that the surgery ends the muscle spasms often triggered by facet joint pain.”
Dr. Chang explains the painful syndrome that can be best treated with this surgery:
Facet joint syndrome: Facet joint syndrome (also sometimes called facet disease) progresses as the discs between vertebrae become thinner, resulting in more stress being placed on the facet joints. This syndrome is most common in seniors or the very active, where increased stress between facet joints causes inflammation and the formation of spinal bone spurs. This process can lead to arthritis, which infamously can result in pain upon joint movement.
Often, for patients of facet joint syndrome, the first step in treating chronic pain in the neck or lower back will be with non-surgical approaches including medication and physical therapy. But if these treatments fail to provide adequate relief, a more advanced diagnostic technique, called a medial branch block injection, is employed. This technique, which is performed by Dr. Chang at Atlantic Spine Center, consists of an injection of an anesthetic agent to the space immediately surrounding the joint. Depending on whether or not back or neck pain is alleviated by the anesthetic agent, diagnostic information can be obtained. If pain does not subside, it can be concluded the pain was not emanating from the joint.
What is Endoscopic Facet Rhizotomy?
The word “rhizotomy” means “nerve destruction,” and endoscopic facet rhizotomy surgery uses heat energy to extinguish tiny nerve fibers that send pain signals from the facet joints to the brain. The procedure only requires a small incision (compared to traditional “open” surgery) and can provide significant neck or lower back pain relief without disrupting the architecture of the spine.
Pain can result from diseased facet joints in the neck, shoulders, mid-back, ribs, chest, lower back, buttocks, groin or legs. To say it another way, facet joint pain can affect many vital areas of the body resulting in chronic pain and a diminished quality of life for sufferers. By destroying (“ablating”) these exact nerve fibers, endoscopic facet rhizotomy can greatly improve patients’ lives by precisely targeting the source of this pain, says Dr. Chang.
The short surgery involves the use of a local anesthetic, x-ray guidance and direct visualization through a microscopic camera to guide an electrocautery device to destroy nerves supplying sensation to damaged facet joints. “The relief experienced by most patients who undergo this procedure can last for years,” adds Dr. Chang.
Electing endoscopic facet rhizotomy over radiofrequency ablation
Today, the most common treatment performed by pain management doctors after a patient has been diagnosed with facet syndrome with a positive medial branch block is radiofrequency ablation. This procedure uses heat from electrical currents administered to the patient via a needle to numb effected nerves. While radiofrequency ablation deadens a small area around the nerve and is expected to last roughly 6 months before the nerves grow back, endoscopic rhizotomy can affect a much larger area through direct visualization, resulting in much longer periods of pain relief.
Dr. Chang concludes that with endoscopic facet rhizotomy “the relief experienced by most patients who undergo this procedure can last for months or even years. This reprieve is profoundly welcomed from people with chronic neck or lower back pain.”
Watch our 3D animated Educational Video on Endoscopic Facet Rhizotomy
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