Endoscopic Facet Rhizotomy

Endoscopic Facet Rhizotomy

The Endoscopic Rhizotomy is the least invasive outpatient procedure that effectively provides up to 5 years of pain relief for patients suffering from chronic low back pain and muscle spasms related to facet joint disease.

When patients lean forward they are fine but leaning backward or standing for long periods causes significant low back pain. Patients suffering from low back pain will most likely see a pain management specialist, and receive facet injections, medial branch blocks or percutaneous radiofrequency rhizotomies (RFA) to relieve the pain. If the pain comes back or ideal long term pain relief was not achieved with the RFA, these patients are usually a good candidate for endoscopic rhizotomy treatment. Facet nerve blocks, or medial branch blocks, may be used to confirm the source of pain as coming from the nerve. Patients who have not responded to other conservative interventions such as facet injections, medication and physical therapy may be candidates for Endoscopic Laser Facet Rhizotomy.

Laser facet rhizotomy is a minimally invasive spinal surgery usually done as an outpatient procedure while the patient is under local anesthesia. During the procedure, the surgeon will make a small incision to insert an endoscope (a small flexible tube with a video camera) into the targeted location, so as to see the nerve branches. The surgeon then uses a laser to deaden these nerve branches thereby eliminating the patient’s pain.


  • What Conditions Can Endoscopic Facet Rhizotomy Treat?

    • Lumbar Endoscopic Facet Rhizotomy
    • Chronic low back pain
    • Facet hypertrophy
    • Facet joint arthritis
    • Facet joint injuries
    • Failed back surgery syndrome
    • Whiplash syndromes
  • How Is an Endoscopic Facet Rhizotomy Done?

    The patient is brought to the operating room and is administered with a local anesthetic and intravenous sedation. The surgical targets are marked at the skin level under fluoroscopic guidance (x-rays), and a small cut (about 7 mm) is made on the skin. Then, a tube is inserted to the target. The endoscope is then placed through the tube and the small nerve branches (medial branch) from the nerve root are identified.

    A laser is then used to deaden the nerve branches, which only have a sensory function. Finally, the tube is removed, the incision is closed with a stitch or two, and the endoscopic facet rhizotomy is complete. Upon completion, the patient is encouraged to walk around and is free to leave the surgical center, with a companion, the same day. After a follow-up visit with the surgeon the next day, the patient can go home for a quick recovery.

  • What are the advantages of an Endoscopic Facet Rhizotomy?

    Advantages of endoscopic facet rhizotomy include the following:

    • Minimally Invasive
    • Short recovery
    • High Success rate
    • Minimal or no blood loss
    • Preservation of spinal mobility
    • Small incision and minimal scar tissue formation
    • Same day procedure with no hospitalization (outpatient procedure)

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