What Is Endoscopic Rhizotomy?

Endoscopic rhizotomy is a cutting-edge outpatient procedure designed to relieve pain caused by irritated or damaged nerves in the spine, especially those around the facet joints. These small joints run along the back of your spine and help support movement. When they’re injured or inflamed—often due to trauma—they can cause persistent lower back pain.

Using a tiny camera (endoscope) and special tools, the surgeon identifies and disables the problematic medial branch nerves. These nerves are responsible for transmitting pain signals from the facet joints to your brain. By precisely ablating (or “disconnecting”) them, this procedure stops the pain at its source, without compromising spinal function.

We often recommend this procedure for people with:

• Persistent or recurring facet joint pain
• Pain that responded temporarily to medial branch blocks
• Discomfort after an accident or injury that hasn’t improved with physical therapy or medications

What Is the Difference Between Endoscopic Rhizotomy and Radiofrequency Ablation?

While radiofrequency ablation (RFA) is a more common option, endoscopic rhizotomy provides several unique advantages, including:

• Greater precision thanks to direct visualization
• More complete nerve ablation
• Longer-lasting results
• Less damage to surrounding tissues
• Faster recovery

For patients who have experienced only temporary relief from medial branch blocks or RFA, this advanced technique offers a potentially life-changing alternative.

What Is the Difference Between a Rhizotomy and a Laminectomy?

While both rhizotomy and laminectomy are procedures aimed at alleviating back pain, they differ significantly in their approach, purpose, and recovery.

A laminectomy is a more invasive surgical procedure designed to relieve pressure on the spinal cord or nerves. It involves removing part of the vertebra (the lamina) to create more space in the spinal canal. This procedure is often recommended for conditions like spinal stenosis, herniated discs, or severe nerve compression. While effective for these issues, a laminectomy usually requires a more extended recovery period and may involve more significant post-operative restrictions.

The Procedure: What to Expect

Pre-Op Preparation

Before the procedure, your physician will confirm the diagnosis, usually through physical examination and response to a medial branch block. If your pain improved temporarily with that block, it's a strong sign you're a good candidate.

During the Procedure

• You’ll receive local anesthesia and sedation.
• The surgeon makes a small incision (about the size of a fingernail).
• An endoscope will be inserted, providing real-time imaging.
• The medial branch nerves responsible for pain transmission are identified and carefully ablated.
• The incision is closed with a small stitch or bandage.

The entire procedure typically takes under 60 minutes.

The Recovery Process: Fast & Patient-Friendly

One of the most significant benefits of endoscopic rhizotomy is the quick recovery. Many patients are surprised at how soon they can return to their normal routines.

Immediately After the Procedure

• You'll typically go home the same day.
• Walking is encouraged within hours.
• Mild soreness may persist for a few days and is typically manageable with over-the-counter pain medications.

Restrictions and Guidelines

• Avoid heavy lifting, twisting, or high-impact activity for 2–4 weeks.
• Resume light daily tasks as tolerated.
• Most patients return to their regular activities within a month.

Follow-Up Care

• Your doctor may ask you to keep a pain diary to track progress.
• Physical therapy may be recommended to strengthen surrounding muscles and prevent future flare-ups.

How Long Will the Pain Relief Last?

This is where endoscopic rhizotomy really shines. Traditional RFA might bring pain relief for 6–12 months. In contrast, the endoscopic approach can deliver relief for up to 5 years—and in many cases, even longer.

• Some patients remain completely symptom-free beyond 5 years.
• The procedure can be safely repeated if pain returns due to nerve regeneration.

This makes it not just a short-term fix, but a long-term investment in your quality of life.

What Are the Risks of Endoscopic Rhizotomy?

Like any medical procedure, endoscopic rhizotomy does carry some risks, but they’re generally low. Possible side effects include:

• Mild soreness or bruising at the incision site
• Temporary nerve irritation or numbness
• Very rare cases of infection or bleeding

Choosing a highly experienced spine specialist—like Dr. Zahrai at Alexander Orthopaedics—significantly reduces the side effects of endoscopic rhizotomy and ensures optimal results.

Is Endoscopic Rhizotomy Right for You?

Endoscopic rhizotomy is ideal for individuals experiencing:

• Persistent back pain that hasn’t responded to physical therapy, injections, or medications
• Previous short-term relief from medial branch blocks
• Injury-related back pain, particularly following a car accident
• Facet joint syndrome or arthritis-related back discomfort

It's especially effective for patients who've suffered trauma that left their back sensitive and unresponsive to standard treatments.

Don’t Let Back Pain Control Your Life

If you or someone you care about is struggling with chronic back pain, especially after an injury or accident, it may be time to explore a more effective, lasting treatment.

At Alexander Orthopaedics, our team specializes in endoscopic spine surgery and minimally invasive pain solutions tailored to your unique condition. With a track record of excellence and compassionate, patient-centered care, we're here to help you reclaim your mobility—and your life.

Schedule your consultation today or call us to learn whether endoscopic rhizotomy is the right option for you.