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Endoscopic Rhizotomy

Endoscopic Rhizotomy

An endoscopic rhizotomy is an outpatient procedure that’s one of the least invasive procedures that allows our physician direct visualization of the dorsal ramus branch of nerves including the medial and lateral branch nerves.  These nerves innervate the facet joint and connect the pain signal from your back muscles to your brain.  When our physician directly observes the nerves with an HD endoscope, he can see and ablate the nerves with certainty and provide significant long-term back and neck pain relief.  This least-invasive procedure has significant advantages over the pain management’s percutaneous radiofrequency facet ablation procedure, which is done under a fluoroscopic X-ray.

The endoscopic rhizotomy procedure may be used to treat patients who are suffering from:

  • Chronic back pain
  • Muscle spasms
  • Pain when leaning backward (but leaning forward is fine)
  • Patients who experienced temporary relief with a percutaneous medial branch rhizotomy

Patients report better long-term results from this least-invasive procedure, compared to a traditional percutaneous rhizotomy.  An endoscopic rhizotomy can effectively treat back pain, spasms, and provide chronic back pain relief.

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Endoscopic Rhizotomy

What conditions does Endoscopic Rhizotomy treat?

When is an Endoscopic Rhizotomy Procedure Recommended?

  • If you’ve been experiencing lower back pain for more than six weeks
  • You’ve had a percutaneous rhizotomy before but symptoms have returned
  • Rubbing your lower back increases spasms
  • You’ve experienced pain relief of 50% or more from a medial branch block procedure

How is the procedure performed?

You’ll be given local anesthesia. A tiny incision (about 1/4 of an inch) will be made in the skin and muscle of your back near the facet joint of the vertebrae. A 7mm tube is inserted into the incision so the surgeon can access the medial branch nerve. Next, an HD camera is inserted into the metal tube, which gives the surgeon a high-definition view of the medial branch nerve. Using microscopic instruments, the surgeon will ablate the medial branch nerve.

Once the nerve is treated, the metal tube is extracted. There is no need for a stitch; the surgeon will place a small Band-Aid over your incision.

What are the advantages of Endoscopic Rhizotomy vs. Percutaneous Radiofrequency Facet Ablation?

  • Many patients report long-term relief of three to five years
  • Instead of multiple percutaneous procedures, there is just one procedure
  • Your surgeon will be able to see the nerves that are causing your pain and target them with ablation

What Is the Endoscopic Rhizotomy Success Rate?

From our experience and clinical studies, we can say that endoscopic rhizotomy surgery has been carried out successfully and is effective over a period of three years. This span makes it appropriate for treating back pain caused by arthropathy of lumbar facet joints in which there is no leg pain.

The exact percentage of successes in different studies varies, but the majority of endoscopic rhizotomy treatments we administer are successful.

What do we do?

Providing a thorough diagnosis to know the cause of your pain

Using the least invasive procedure that will relieve your pain quickly

Providing effective follow-up to ensure fast recovery

Ensuring that you remain fit so that you can enjoy long-term relief from pain

Click to watch our patient success story: Anne
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What Is the Endoscopic Rhizotomy Recovery Time?

The endoscopic rhizotomy procedure is usually done on an outpatient basis. Within an hour after the procedure is completed, you’ll be able to return home. Full recovery from this non-invasive, 30-minute procedure takes just a few weeks.

During the recovery period, you’ll be required to come in for follow-up appointments. Physical therapy may be performed to help you gain full strength and mobility. You may also need to take some pain-relieving medication to reduce discomfort during the recovery period.

How long is the recovery and how soon can you return to work?

This type of endoscopic spine surgery takes about thirty minutes and you’ll be ready to go home after the surgery in about an hour. You’ll experience very little if any pain from the procedure. You’ll want to keep in contact with your doctor during your recovery to determine when you can resume your normal activities. Many patients feel better right after the procedure and can go back to work in just a couple of days. Be sure to follow your doctor’s instructions and avoid any heavy lifting until you’ve been medically cleared.

Our very own Baher S. Yanni, MD, sharing his expertise on the endoscopic rhizotomy procedure.


To see if you are a good candidate for an endoscopic rhizotomy, take our pain evaluation questionnaire and someone from our office will get back to you.

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