Rhizotomy stories... good, bad, indifferent?
 

It looks like my next step is a rhizo to ablate the nerves that feed T6-7-8 facets. Please let me know yoru experiences.

Thanks,

Mark

I'm hoping to see some first hand rhizo outcomes too. I'm scheduled to see the PM doctor at Univ Wash Pain Center in Feb.

I had an RFL done at C3/4/5 about 3 months ago. No procedure problems or pain, had splinters that where more uncomfortable.

Post procedure symtoms where no problem as well. Maybe felt a little soar for a couple of days. But nothing that would cause me to take any pain relief meds..

As for whether the procedure helped? I would say my facets at those levels are not my problem. My guess is the slight soarness in my neck after the medial branch masked my current problem. Kind of like you can't feel 2 different pains in the same area at once. If that makes sense.

Hi Mark,

I’m sorry to hear that you are still having problems, that really sucks. I haven’t been on here for some time so I have been trying to catch bits and pieces of what’s gone on. I didn’t realize that you were having such pain.

Well I think you already know my rhizo experiences. It’s what’s kept me going all these years and it’s been very successful in my particular case. I’ve had some new additional pain that started earlier this year that you may recall, but I’m sure it was not from the facets, it is very different.

My last rhizotomy was right at a year ago and I believe that I am still experiencing the benefits from it. I had it done 3 months earlier but then repeated it because there was at least one nerve that was not completely ablated and was still quite angry. That’s the one problem with the procedure, it’s possible that they don’t get in close enough proximity with the nerve to heat it up to the point of ablation.

The rhizotomy prior to last years, lasted almost 2 years. Each time, for me anyways, has been the exact same recovery. For me it’s right at 6 weeks, and for a good part of that 6 week period is even more painful then prior to the procedure. But I have always used that as a gauge for determining the effectiveness of the procedure. If the nerves are properly ablated, they are going to cause all kinds of various sensations during that period of “dying off”.

As with any procedure, the skill and experience of the doctor is everything. Knowing proximity placement and listening to the patients feed back is everything when it comes to rhizomoty. If the doctor is in a rush for time….forget it, it can be tedious to find the exact ideal location before they start the ablation cycle. Each nerve can potentially take 10-15 minutes.

As you know, I have had many of these over the last six years. Some lasting only 6-9 months and some much longer. I will continue to get more in the future as well, for me it’s made that much of a difference.

Give me a call if you like Mark, I can give you much more detail as far as what to expect during the procedure and what to ask for.

Regards,
Larry

Larry, Thanks for the excellent post.

Yes, thanks Larry.

I saw a UCLA pain medication doc/interventional type whom I have left. I asked him about doing an S-I rhizotomy and he whined that it would take ~ 7 locals and has ~ 50% rate. Sure seems worth it vs. being pumped w/steroids. Anyways, I'm hoping to hear experiences too so sorry, off-topic.

The SI RF ablation is a completely different animal... nothing like the facet rhizo. The surgeons that I have discussed the SI rhizo with all say that the SI is too highly innervated. There is so much ablation that must take place... might as well have a bbq. With so much to do, there is so much to miss. I have not heard good things about SI ablations from anyone. I'm sure that there are proponents out there... I have not run into them.

Mark

some ppl have posted their experiences below. i apologize if it not acceptable to post the link.
Rhizotomy/Radio Frequency Nerve Ablation? - HealthBoards Message Boards

re thoracic facets
 

Mark,
How common is it to do rhizotomy on thoracic facets or how many patients has your paticular doctor done this on? Good results? So forth so on...

I will be having a rhizotomy from C2-C6 (left side) in a few hours. I had good success with the first block. Not so much with the second, but I have decided to move forward with it. I'll let everyone know how it goes.

Had the radio frequency ablation and am back home. The surgeon said that from my pain responses during the procedure, he burned each level 6 times. Most only need 1. The anasthesiologist also could not believe that I was as awake or coherent as I was with all of the drugs he gave me. I hear that all of the time so whatever.

I feel better right now. The pain I have on the left side of my neck is more of a severe soreness as opposed to other pain however I always seem to feel better right after procedures and then take a downswing. From those who have had the procedure that I've talked to it will take a few days to a few weeks to feel the full effect. I will keep updating on my progress.

Jason, I'll be following your rhizo progress. Mine was approved and will probably start on Jan 13th.

You signature file is amazing. 4 surgeries this year... that's a bit extreme. I wonder who the champ is. (Mr.B had 5 in 10 months, but 3 were discectomy/decompression surgeries.)

I am soon having 4 lever rhizotomy. Will let you know how it goes.

But not FJ rhizotomy. Surgeon will cut sinu-vertebral nerve pathways.

Mark-

Sorry to hear how bad you are.

I had rhizotomy over a year ago. NO relief. My neck pain was awful for about 2 weeks following procedure.

I didn't think it would help me either but felt that I had to go through it as it was as much diagnostic as for pain relief.

I hope you feel better.

Thanks everyone, for the replies. I look forward to reading more about the recent rhizotomy experiences. Mine was scheduled for Wednesday (a couple of days ago). I had scheduled it, because the November injection was so positive but I was still so bad. I wanted to jump straight to the rhizotomy. Over these last couple of weeks I continued to improve. I sent my Dr. a fax. I was equivocating on more injections vs. the rhizotomy. The phone call from him was quite funny. I was trying to get him to tell me what I should do. He kept on saying that he would do whatever I wanted.

I decided that we can always a plate tissue later. We can't go in the other direction. I canceled the rhizotomy and had another round of facet injections on Monday (four days ago). While I'm still not great, I am improving. My level of functionality is also improving. I still experience substantial pain, but that is because I'm doing so much more. I'm still taking 60 mg a day of oxy. I'm very tempted to start cutting back and actually have been a little bit, but I think I should enjoy the success and let things settle down before I do any serious reduction in my meds.

I'll update my T-spine thread separately. I think it all still get to the rhizotomy but at least I'll be sure when I do. I hate to drag this out, but we can always ablate tissue later.

All the best,

Mark

Facet Injections almost a miracle for me
 

(I mean *Facet Rhiztomy*)..

Dr. Leticia Lau at Cedars told me that she knows a method of giving an S-I rhizotomy that doesn't incorporate 7 needles and has a strong success rate. I believe her: she diagnosed my facet problems and despite knowing that I have a blown S-I disc, she speculated that if I have facet issues, a rhizotomy could get rid of all my pain. The Cedars Pain Group may all be so great technically but they are fervently anti any "narcotics", including Vicodin it seems due to fears of "opiate hyperalgesia".

Well, I did have facet injections from L2-S-1 and wish I was fried six times or so! I had a few days of (pardon the shout) of ZERO back pain. It was like how I used to be before 8 years. I was utterly mindblown and reflected on the deadening psychological state I lived in combating pain with meds, etc.

My response now is not full but I am able to 1/2 my morphine dose and will do everything to taper more.

I do not know how many facet injections they can give/year. If anyone knows, please lemme know. I want him to go in there and fry those nerves.

I have one article I think from Medscape that says ~ 50-60% of back pain is from the facets. Why this happens mechanically, I do not know why. I will try to hunt the article again.

Cheers...

Reply
 

You and me both Mark. I thought I was in the clear after 4 months of completely pain free living. But Im back to enjoying nerve pain again over the past 2 months, seems to now be at T1 -T3 (they are all tender) and so bad that its causing me nausea. Its getting worse as time goes on. Back to pain pills again. Just great. Well, at least I had 4 months of pain free living. Just goes to show that whether its fusion or ADR, we just cant win now can we? Sorry to hear about your problems again. Thanks for the update as I have been wondering how things were going for you.

Do you or anyone know how many rhizotomies/year can be performed for the same lumbar (or thoracic level) per year?

It makes sense that they must go from a different angle to avoid the scar tissue from the "darning needle" used to go do deep into the spine. Amazing technology.

We know the best spinal surgeons in our cities but interventionists who conduct rhizotomies? Here, I'm in the dark. I suspect that Cedars' Pain Center is hot but their idea of pain mgt. in terms of meds is Baclofen and NSAIDS. ;)

How can we find interventionists who will burn each nerve six times vs. one? ("Sure kid, I'll get ya six times" and only do one - my luck). These procedure areas are kinda like factories imo.