Facet Joint Rhizotomy

What is it?
A facet rhizotomy is a procedure involving placing a very small needle adjacent to the pain nerve fibers that originate near a facet joint, and placing a localized heat lesion in the nerve in order to treat your pain.

How is it done?
The procedure is performed under light IV sedation, with the patient sleepy, but awake.  X-rays are used to find the position of the nerve, and a small needle is placed with the tip adjacent to the nerve itself.  Initially, the nerve is stimulated with the electrode to insure that it is in the proper position.  Once we are sure that the electrode is in the correct position, a heat lesion is then produced by heating up the tip of the electrode.

How long does it take?
The procedure takes approximately 45 minutes plus approximately 40 minutes of recovery time.

What are the risks?
The procedure is very safe, and the risks are similar to those expected with any type of needle-guided interventional procedure.  The most common potential complications including bleeding, infection, or possibly nerve damage, although these are very unlikely.

The day of your procedure:
On the day of your procedure, report directly to the Short Stay Unit on the second floor of the Acute Care Pavilion at least one hour prior to your scheduled appointment time for registration. Please bring your insurance information with you. 

Wear loose comfortable clothing; please do not wear dresses or skirts.

Your must have a driver accompany you on the day of the procedure.  You will receive light IV sedation for the procedure.  If a driver is unavailable, the procedure will be canceled per hospital policy.  We must be able to contact your driver before, during and after your procedure either by phone or pager (pagers are available at the Short Stay Unit front desk…please ask).

Plan to be at the hospital up to 3 hours.  Please do not bring young children with you. 

Please do not eat or drink for at least 4 hours prior to the procedure.  A snack will be provided after the procedure.

You may take pain medication up to 2 hours prior to the exam time with a sip of water.  If you receive pain medication by a skin patch, you must call the nurses at 443-481-1385 for further instructions.  You may bring your pain medication with you to take after the procedure. 

If you are DIABETIC:
If your exam is before 12 noon, do not eat or take any diabetic medication before the procedure.  Bring your medication with you.

If your exam is 12 noon or after, please eat breakfast before 7:00 am and take your diabetes pill or ½ your morning dose of insulin.  Bring your medication with you.

Other MEDICATIONS:
Please take all of your routinely prescribed medications the day of the procedure including blood pressure, heart, thyroid pills, etc. 

NOTE: If you take BLOOD THINNERS OR ANTIPLATLET medications (examples: Coumadin, Heparin. Plavix or Lovenox) please contact the prescribing physician to discuss your risk of stopping these medications for your test/procedure.  We REQUIRE that Coumadin is stopped for 5 days prior to your test/procedure, and that Plavix is stopped for 7 days prior to your test/procedure.   Please call 443-481-1385 for further instructions or if you have questions about your medications.    YOUR PROCEDURE WILL BE CANCELED IF THESE MEDICATIONS HAVE NOT BEEN STOPPED. 

You must be healthy the day of the exam.  You cannot have a fever, infection, sore throat or cough. Please call 443-481-1385 Monday through Friday 8 am to 5 pm; leave a message and one of the nurses will call you back to discuss your possible illness.

There you will be seen by Dr. Thompson, Dr. Eckel or Dr. Clark before the procedure to discuss your condition, x-rays, and purpose of the test.

After the procedure:
Your back may be sore for several days after the procedure, and this discomfort may be treated with either pain medication and/or application of ice.  Within a few days, you should begin to notice an improvement in your facet-related back pain, probably similar to the response that you once had from facet joint injections, although considerably more long lasting. 

You will be given written discharge instructions before you leave and the procedure will be explained to you and your driver. The films that you brought with you will be returned upon your discharge. 

Your referring physician will receive a dictated report from Dr. Thompson, Dr. Eckel or Dr. Clark 8 to 10 days following your visit.

If you are in physical therapy, check with your referring physician before resuming treatment.  Dr. Thompson, Dr. Eckel and Dr. Clark recommend delaying any physical therapy for several weeks post procedure.

If you have any questions regarding your procedure, please call the nurses at 443-481-1385.