Non-Surgical Treatment

Facet Joint Rhizolysis

Rhizolysis is a term used to describe a procedure in which a special probe is placed down close to a nerve that comes from the facet joints of the lumbar spine. By using radio frequency stimulation, the nerve is heated which stops it sending signals back to the spine.

The position of this nerve, which is called the medial branch of the posterior primary ramus, is sited at a specific anatomical spot in the lumbar spine, which can be found under image intensification (x-ray). The rhizolysis procedure has the ability to identify how close the probe is to the nerve requiring treatment, and to make sure that it is not too close to deeper nerves which supply the muscles. The probe is placed through the skin, which has been anaesthetised with local anaesthetic, and once the probe is in the correct position, more local anaesthetic is used so that the actual process of lesioning the nerve is less painful.


Rhizolysis Procedure

Patients are asked to keep a pain diary describing their symptoms in the first day and the first, second and third weeks following the procedure, on a scale of 1-10, where 10/10 is the worst pain imaginable and 1/10 is a dull ache, recording scores for the back as well as for any leg symptoms that may have been described prior to the procedure. The purpose of this is to try to assess whether there has been a change in the degree of pain following the procedure.


Success Rates of Facet Joint Rhizolysis

If the procedure is successful then patients can gain a good reduction in their symptoms from anywhere between three months to a year. Unfortunately, a proportion of patients do not respond, but the success rate for those patients who have had successful facet joint injections will be in the region of 60-70%. It is possible to repeat the procedure in those patients for whom it has been successful, but who experience a recurrence of similar symptoms.

You will be asked to attend the X-ray Department at New Hall Hospital and the operation takes 25-45 minutes. You will be able to walk out of the X-ray Department immediately afterwards, and we would ask you to arrange for a friend or relative to drive you home. Please bring any x-rays and scans that are in your possession to the appointment.