It is estimated that 25 to 30% of the population in Europe suffers from chronic pain.
For most people who develop pain in the lower back or neck, it tends to go away after about 3 months. But for a few people, this pain becomes chronic or persistent, and begins to have a serious impact on their ability to go about normal daily life. What’s more, these people often try to hide their symptoms in order to not be a burden on their loved ones.
One of the sources of chronic back pain can be worn-out facet joints in the spine.
Facet joint pain cannot be precisely diagnosed by any specific clinical characteristics; the only way to diagnosis it precisely it through diagnostic infiltrations.
How does rhizolysis work?
Rhizolysis works by causing a controlled lesion on the nerve fibers that connect to the degenerated facet joint. The purpose of destroying these small nerve fibers is to interrupt the pain signal.
It is an outpatient procedure, performed in an operating room, with the patient lying either face up or face down, in a position that is relatively comfortable. The patient will be sedated, but general anesthesia is not required.
This lesion is made with electrodes, which are placed guided by X-ray monitoring. In all cases, a test is performed prior to starting the definitive treatment, to minimize any risk as much as possible.
- Lumbar rhizolysis: For lumbar rhizolysis, the patient lies face down, is given sedation, and the skin of the area involved is cleaned with antiseptics. Then, the access point of the electrodes is checked using an X-ray machine. Local anesthetic is injected at these points and the procedure is started.
After confirming the precise location of the electrodes, they are activated, beginning first with a low intensity. If this does not provoke a motor response in the patient’s legs or feet, it is considered safe to continue the treatment. - Cervical rhizolysis: When rhizolysis is for the cervical spine, the patient is positioned lying face up. After the skin is cleaned with antiseptics, the access point for the electrodes is confirmed using an X-ray machine. Local anesthetic is injected into these points and the procedure is started.
In cervical rhizolysis, we are dealing with a smaller treatment target than in the case of a lumbar procedure, so the precise location for the electrodes must be confirmed along with the first low-intensity stimulation. If there are no motor responses in the upper extremities, it is considered safe to continue the procedure.
What is the goal?
The goal of rhizolysis is to partially or completely eliminate pain in the cervical and lumbar spine, and with minimal risk to the patient, so they can enjoy a better quality of life.
A great benefit of the procedure is that is makes it possible to reduce the patient’s need for pain medications, and it reduces the number of cases that need spine surgery.
Because it is a minimally invasive technique, it can even be performed on patients that are considered fragile.
When can it be helpful?
Rhizolysis is considered a treatment option in cases of pain that has lasted longer than 3 months in the lumbar area, the outer sides of the buttocks, and pain radiating from the back of the thigh to the back of the knee.
At the level of the cervical spine, it can be used in cases of constant neck pain, including pain that continues to the shoulders.
It can also be useful for people whose back pain makes it hard for them to stand for very long, or who have limited spinal mobility due to pain.
When should it not be used?
Rhizolysis is not recommended for cases of neuropathic pain in the arms or legs, whether it affects strength or not.
It should also not be applied in a patient with a high fever and very sudden weight loss.
Does it require a hospital stay?
Rhizolysis is an outpatient procedure and does not require a stay in the hospital. It is minimally invasive, with virtually non-existent blood loss, and does not require general anesthesia.
Are there any risks?
This is a very safe procedure. Because there is no incision necessary, and a blood loss is minimal, it does not pose the same risks as surgery.
In fact, risk is estimated at less than 1% for pain in the puncture area, or allergic reactions on the skin due to local anesthetics.
We hope that this post has helped you understand the procedure of rhizolysis for treatment of spinal pain.
Because chronic spinal pain is a problem that affects so many people in a variety of ways, it's important to know that there are new alternative treatments to conventional surgery.
These are techniques that involve minimal risk, aimed at improving the quality of life of our patients.
At Instituto Clavel, we have a great team of professionals in our Pain Clinic, with extensive experience in rhizolysis.
So, if you would like to know more about this treatment and find out if it might be helpful for you, we encourage you to make an appointment with one of our expert doctors.
Dra. Vega
Doctor
Specialist in Anesthesiology and Pain Management
Categories: Spine treatments, Prevention, Lumbar pain