Endoscopic Rhizotomy for Chronic Neck and Back Pain
Endoscopic rhizotomy is a minimally invasive spinal procedure used to treat chronic pain originating from the facet joints of the spine. At the Spine Institute of North America, our providers use this technique to precisely identify and disrupt pain-transmitting nerves that cause persistent neck or back discomfort. This treatment can be effective in helping patients achieve long-term pain relief and improved function.
Who Is a Candidate?
An endoscopic rhizotomy procedure may be recommended for patients with chronic neck or lower back pain that has not improved with conservative treatments such as medication, physical therapy or injections.
Common conditions this procedure can help treat include:
Chronic neck or lower back pain
Facet joint arthritis or facet joint syndrome
Recurrent lower back muscle spasms
Failed back surgery syndrome
Spinal stiffness, tenderness, or reduced range of motion
Physicians may recommend endoscopic rhizotomy when:
Lower back pain persists for more than six weeks despite treatment
Pain worsens with pressure or massage over the affected area
Symptoms return after a prior percutaneous rhizotomy
A diagnostic medial branch block provides partial but incomplete pain relief
How Endoscopic Rhizotomy Works
Endoscopic rhizotomy is an outpatient procedure performed under local anesthesia with mild sedation.
During the procedure, the doctor:
Makes a small incision near the affected facet joint.
Inserts a thin endoscope with a high-definition camera to visualize the medial branch nerves.
Uses specialized instruments to precisely ablate (disrupt) the nerves that transmit pain signals.
The surgeon can directly visualize the nerves, helping improve treatment accuracy while minimizing damage to surrounding tissue.
Endoscopic Rhizotomy vs. Radiofrequency Ablation
Both endoscopic rhizotomy and radiofrequency ablation (RFA) can treat facet joint–related spinal pain. Each procedure targets the medial branch nerves that cause your pain.
However, endoscopic rhizotomy offers several potential advantages:
Single outpatient treatment: Radiofrequency ablation often requires repeat procedures as nerves regenerate. Endoscopic rhizotomy may provide longer-lasting results with fewer repeat interventions.
Direct nerve visualization: The endoscopic approach allows the surgeon to visually identify and treat the affected nerves, improving procedural accuracy.
Longer duration of relief: While RFA typically provides pain relief for several months, an endoscopic rhizotomy for neck and back pain may relieve symptoms for three to five years.
Recovery and Post-Procedure Care
As an outpatient procedure, most patients generally:
Are discharged within about one hour after the procedure
Resume light daily activities within a few days
Return to non-labor-intensive work within several days
Surgeons often recommend a structured physical therapy program during the recovery period to restore strength, flexibility, and spinal stability. Most patients gradually return to normal activities within several weeks.
Clinical research has demonstrated that endoscopic rhizotomy can significantly reduce axial spinal pain. Studies, including research conducted in part by Baher Yanni, MD, suggest that this procedure may provide longer-lasting pain relief, reduced opioid use, and improved outcomes compared with conventional radiofrequency ablation techniques.
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
For patients with chronic facet joint pain, endoscopic rhizotomy provides a targeted, minimally invasive option that can:
Reduce symptom severity, often for up to three to five years for many patients
Improve mobility and daily comfort
Decrease reliance on pain medications
Minimize the need for repeated procedures
Our very own Baher S. Yanni, MD, sharing his expertise on the endoscopic rhizotomy procedure.
Schedule a Consultation for Chronic Neck or Back Pain
Spine INA has a proven history of helping patients like you find relief. If you are experiencing persistent neck or lower back pain, our specialists can evaluate your condition and determine whether endoscopic rhizotomy or another minimally invasive spine treatment may be right for you.
