Endoscopic Spine Surgery

Spinal Fusion Alternatives

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Endoscopic Facet Rhizotomy

What Is Endoscopic Facet Rhizotomy?

At Atlantic Spinal Care, we have built a strong reputation based on the high success rates of our surgery. Our endoscopic facet rhizotomy procedure is a true minimally invasive spine surgery during which our surgeons use a laser to deaden the affected nerves. With the guidance of x-rays, our endoscopic rhizotomy is completed without damaging surrounding muscles or soft tissue like traditional spine surgery does.

Advantages of endoscopic facet rhizotomy surgery include the following:

  • Minimally invasive
  • Small incision and minimal scar tissue formation
  • Short recovery
  • Same day surgery with no hospitalization (outpatient procedure)
  • High success rates
  • Minimal to no blood loss
  • Local anesthesia
  • Preservation of spinal mobility

What Conditions Can Endoscopic Facet Rhizotomy Treat?

Endoscopic facet rhizotomy is often used to relief pain caused by spinal conditions involving the face joints.

  • Chronic low back pain
  • Facet hypertrophy
  • Facet joint arthritis
  • Facet joint injuries
  • Failed back surgery syndrome
  • Whiplash syndromes

When Is Endoscopic Facet Rhizotomy Recommended?

Endoscopic facet rhizotomy is generally recommended for the following situations:

  • The patient has lower back pain for more than 6 weeks and the pain does not respond to conservative treatments.
  • Palpation of the facet joints provokes deep tenderness and muscle spasm.
  • The patient has limited range of motion in the lumbar spine, particularly upon extension (bending backwards).
  • Facet joint blocks or medial branch nerve blocks confirm that lower back pain is from facet joint diseases.

How Is Endoscopic Facet Rhizotomy Done?

The patient is brought to the operating room and is administered with a local anesthetic and intravenous sedation. The surgical targets are marked at the skin level under fluoroscopic guidance (x-rays), and a small cut (about 7 mm) is made on the skin. Then, a tube is inserted to the target. The endoscope is then placed through the tube and the small nerve branches (medial branch) from the nerve root are identified. A laser is then used to deaden the nerve branches, which only have a sensory function. Finally, the tube is removed, the incision is closed with a stitch or two, and the endoscopic facet rhizotomy is complete.

Upon completion, the patient is encouraged to walk around and is free to leave the surgical center, with a companion, the same day. After a follow-up visit with the surgeon the next day, the patient can go home for a quick recovery.

I like Dr. Liu's technique, he is more detailed, and he told me what he could and couldn't do. He is detailed and very much a perfectionist.
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- Karen Jordan