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Re: Rhizotomy??? Good/bad?

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Hi Amy,

A facet rhizotomy is considered for pain generated by one or more facet

joints, which are the paired joints at the back of each vertebra. This type of

pain would be felt as a tender spot over the particular painful joint along the

side of the neck (a little closer to rear of neck-your pain doctor has probably

pressed on them to see if they are tender). This type of pain also refers pain

(depending on the level of the painful joint) to the back of the neck(higher to

middle cervical vertebra), shoulder blade areas(lower cervical vertebra) and

back of head-(higher cervical vertebra))

The facet rhizotomy itself involves inserting a special needle (attached to

electrical current)close to the (medial)nerve that comes out of the joint. The

location is checked by xray, then steroid and anesthetic is released, and then

the electrical current is turned on to fry the nerve. The nerve dies back but

not permanently. Pain relief can last for many months to a year and a half

depending on when the nerve grows back.

Prior to doing the facet rhizotomy, the pain doctor should have done the

specific facet joint injections (close but not usually directly into the joint)

and you should have gotten pain relief.

The nerve that the pain doctor is trying to fry contains sensory nerves

coming from the joint so damaging them relieves the pain, but also the nerve

bundle contains motor nerves that control the little muscles (multifidous) that

stabilize the vertebra. I don't know how these " needle jockeys " know they are

getting the sensory nerves without damaging the motor nerves also. I've read

that one of the ways they know they got the right nerve is that the little

muscles at that point stop working (by emg test). My pain doctor told me not to

worry because he could get the sensory nerves only. I actually think he lied

because as far as I can tell motor and sensory neurons come bundled together in

the medial nerve. Anyway apparently, if you just do rhozotomy on one or at most

3 facet joints (only one side?)in the neck, instability isn't a problem because

there is a lot of overlap in the muscles so others can take over. If rhizotomy

is done in the lower back instability can be a problem.

I have had facet rhizotomy done for painful facet joints but I didn't have pain

relief because as it turned out my pain, in spite of advanced arthritic changes

throughout my cervical spine, stemmed from my poor posture all along. Fixing my

posture and strengthening muscles in upper back and between shoulder blades gave

me more pain relief than anything the pain doctor could do. (I just felt along

my facet joints and they are still tender but generally don't give me any

problems.)

Rochelle

>

> Has anyone had a facet rhizotomy. My pain management dr. is considering it

and it seems like a good thing. I'm at the point I'll try just about anything

to relieve the pain. But my surgeon said this is evasive and you might want to

reconsider.

>

> Anyone have any luck with rhizotomy?

> Thanks,

> Amy

>

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Share on other sites

Hi Amy,

A facet rhizotomy is considered for pain generated by one or more facet

joints, which are the paired joints at the back of each vertebra. This type of

pain would be felt as a tender spot over the particular painful joint along the

side of the neck (a little closer to rear of neck-your pain doctor has probably

pressed on them to see if they are tender). This type of pain also refers pain

(depending on the level of the painful joint) to the back of the neck(higher to

middle cervical vertebra), shoulder blade areas(lower cervical vertebra) and

back of head-(higher cervical vertebra))

The facet rhizotomy itself involves inserting a special needle (attached to

electrical current)close to the (medial)nerve that comes out of the joint. The

location is checked by xray, then steroid and anesthetic is released, and then

the electrical current is turned on to fry the nerve. The nerve dies back but

not permanently. Pain relief can last for many months to a year and a half

depending on when the nerve grows back.

Prior to doing the facet rhizotomy, the pain doctor should have done the

specific facet joint injections (close but not usually directly into the joint)

and you should have gotten pain relief.

The nerve that the pain doctor is trying to fry contains sensory nerves

coming from the joint so damaging them relieves the pain, but also the nerve

bundle contains motor nerves that control the little muscles (multifidous) that

stabilize the vertebra. I don't know how these " needle jockeys " know they are

getting the sensory nerves without damaging the motor nerves also. I've read

that one of the ways they know they got the right nerve is that the little

muscles at that point stop working (by emg test). My pain doctor told me not to

worry because he could get the sensory nerves only. I actually think he lied

because as far as I can tell motor and sensory neurons come bundled together in

the medial nerve. Anyway apparently, if you just do rhozotomy on one or at most

3 facet joints (only one side?)in the neck, instability isn't a problem because

there is a lot of overlap in the muscles so others can take over. If rhizotomy

is done in the lower back instability can be a problem.

I have had facet rhizotomy done for painful facet joints but I didn't have pain

relief because as it turned out my pain, in spite of advanced arthritic changes

throughout my cervical spine, stemmed from my poor posture all along. Fixing my

posture and strengthening muscles in upper back and between shoulder blades gave

me more pain relief than anything the pain doctor could do. (I just felt along

my facet joints and they are still tender but generally don't give me any

problems.)

Rochelle

>

> Has anyone had a facet rhizotomy. My pain management dr. is considering it

and it seems like a good thing. I'm at the point I'll try just about anything

to relieve the pain. But my surgeon said this is evasive and you might want to

reconsider.

>

> Anyone have any luck with rhizotomy?

> Thanks,

> Amy

>

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Share on other sites

Hi Amy,

A facet rhizotomy is considered for pain generated by one or more facet

joints, which are the paired joints at the back of each vertebra. This type of

pain would be felt as a tender spot over the particular painful joint along the

side of the neck (a little closer to rear of neck-your pain doctor has probably

pressed on them to see if they are tender). This type of pain also refers pain

(depending on the level of the painful joint) to the back of the neck(higher to

middle cervical vertebra), shoulder blade areas(lower cervical vertebra) and

back of head-(higher cervical vertebra))

The facet rhizotomy itself involves inserting a special needle (attached to

electrical current)close to the (medial)nerve that comes out of the joint. The

location is checked by xray, then steroid and anesthetic is released, and then

the electrical current is turned on to fry the nerve. The nerve dies back but

not permanently. Pain relief can last for many months to a year and a half

depending on when the nerve grows back.

Prior to doing the facet rhizotomy, the pain doctor should have done the

specific facet joint injections (close but not usually directly into the joint)

and you should have gotten pain relief.

The nerve that the pain doctor is trying to fry contains sensory nerves

coming from the joint so damaging them relieves the pain, but also the nerve

bundle contains motor nerves that control the little muscles (multifidous) that

stabilize the vertebra. I don't know how these " needle jockeys " know they are

getting the sensory nerves without damaging the motor nerves also. I've read

that one of the ways they know they got the right nerve is that the little

muscles at that point stop working (by emg test). My pain doctor told me not to

worry because he could get the sensory nerves only. I actually think he lied

because as far as I can tell motor and sensory neurons come bundled together in

the medial nerve. Anyway apparently, if you just do rhozotomy on one or at most

3 facet joints (only one side?)in the neck, instability isn't a problem because

there is a lot of overlap in the muscles so others can take over. If rhizotomy

is done in the lower back instability can be a problem.

I have had facet rhizotomy done for painful facet joints but I didn't have pain

relief because as it turned out my pain, in spite of advanced arthritic changes

throughout my cervical spine, stemmed from my poor posture all along. Fixing my

posture and strengthening muscles in upper back and between shoulder blades gave

me more pain relief than anything the pain doctor could do. (I just felt along

my facet joints and they are still tender but generally don't give me any

problems.)

Rochelle

>

> Has anyone had a facet rhizotomy. My pain management dr. is considering it

and it seems like a good thing. I'm at the point I'll try just about anything

to relieve the pain. But my surgeon said this is evasive and you might want to

reconsider.

>

> Anyone have any luck with rhizotomy?

> Thanks,

> Amy

>

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Share on other sites

Hi Amy,

A facet rhizotomy is considered for pain generated by one or more facet

joints, which are the paired joints at the back of each vertebra. This type of

pain would be felt as a tender spot over the particular painful joint along the

side of the neck (a little closer to rear of neck-your pain doctor has probably

pressed on them to see if they are tender). This type of pain also refers pain

(depending on the level of the painful joint) to the back of the neck(higher to

middle cervical vertebra), shoulder blade areas(lower cervical vertebra) and

back of head-(higher cervical vertebra))

The facet rhizotomy itself involves inserting a special needle (attached to

electrical current)close to the (medial)nerve that comes out of the joint. The

location is checked by xray, then steroid and anesthetic is released, and then

the electrical current is turned on to fry the nerve. The nerve dies back but

not permanently. Pain relief can last for many months to a year and a half

depending on when the nerve grows back.

Prior to doing the facet rhizotomy, the pain doctor should have done the

specific facet joint injections (close but not usually directly into the joint)

and you should have gotten pain relief.

The nerve that the pain doctor is trying to fry contains sensory nerves

coming from the joint so damaging them relieves the pain, but also the nerve

bundle contains motor nerves that control the little muscles (multifidous) that

stabilize the vertebra. I don't know how these " needle jockeys " know they are

getting the sensory nerves without damaging the motor nerves also. I've read

that one of the ways they know they got the right nerve is that the little

muscles at that point stop working (by emg test). My pain doctor told me not to

worry because he could get the sensory nerves only. I actually think he lied

because as far as I can tell motor and sensory neurons come bundled together in

the medial nerve. Anyway apparently, if you just do rhozotomy on one or at most

3 facet joints (only one side?)in the neck, instability isn't a problem because

there is a lot of overlap in the muscles so others can take over. If rhizotomy

is done in the lower back instability can be a problem.

I have had facet rhizotomy done for painful facet joints but I didn't have pain

relief because as it turned out my pain, in spite of advanced arthritic changes

throughout my cervical spine, stemmed from my poor posture all along. Fixing my

posture and strengthening muscles in upper back and between shoulder blades gave

me more pain relief than anything the pain doctor could do. (I just felt along

my facet joints and they are still tender but generally don't give me any

problems.)

Rochelle

>

> Has anyone had a facet rhizotomy. My pain management dr. is considering it

and it seems like a good thing. I'm at the point I'll try just about anything

to relieve the pain. But my surgeon said this is evasive and you might want to

reconsider.

>

> Anyone have any luck with rhizotomy?

> Thanks,

> Amy

>

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Share on other sites

I have had the RF cauterization done three times so far.  Each time it helps

for about 6 glorious months.  6 months with only moderate pain is a gift from

God.  I recommend it to anyone who is eligible for it.  Know that there will

be increased pain in the area where they cauterize the nerves.  The doctors say

3-4 days but it has lasted as long as 6 weeks.  The pain is different and

bearable.

Joe Grant

From: rccoc1977 <rccoc1977@...>

Subject: Re: Rhizotomy??? Good/bad?

neck pain

Date: Thursday, January 28, 2010, 11:18 AM

 

Hi Amy,

A facet rhizotomy is considered for pain generated by one or more facet joints,

which are the paired joints at the back of each vertebra. This type of pain

would be felt as a tender spot over the particular painful joint along the side

of the neck (a little closer to rear of neck-your pain doctor has probably

pressed on them to see if they are tender). This type of pain also refers pain

(depending on the level of the painful joint) to the back of the neck(higher to

middle cervical vertebra), shoulder blade areas(lower cervical vertebra) and

back of head-(higher cervical vertebra))

The facet rhizotomy itself involves inserting a special needle (attached to

electrical current)close to the (medial)nerve that comes out of the joint. The

location is checked by xray, then steroid and anesthetic is released, and then

the electrical current is turned on to fry the nerve. The nerve dies back but

not permanently. Pain relief can last for many months to a year and a half

depending on when the nerve grows back.

Prior to doing the facet rhizotomy, the pain doctor should have done the

specific facet joint injections (close but not usually directly into the joint)

and you should have gotten pain relief.

The nerve that the pain doctor is trying to fry contains sensory nerves coming

from the joint so damaging them relieves the pain, but also the nerve bundle

contains motor nerves that control the little muscles (multifidous) that

stabilize the vertebra. I don't know how these " needle jockeys " know they are

getting the sensory nerves without damaging the motor nerves also. I've read

that one of the ways they know they got the right nerve is that the little

muscles at that point stop working (by emg test). My pain doctor told me not to

worry because he could get the sensory nerves only. I actually think he lied

because as far as I can tell motor and sensory neurons come bundled together in

the medial nerve. Anyway apparently, if you just do rhozotomy on one or at most

3 facet joints (only one side?)in the neck, instability isn't a problem because

there is a lot of overlap in the muscles so others can take over. If rhizotomy

is done in the lower back

instability can be a problem.

I have had facet rhizotomy done for painful facet joints but I didn't have pain

relief because as it turned out my pain, in spite of advanced arthritic changes

throughout my cervical spine, stemmed from my poor posture all along. Fixing my

posture and strengthening muscles in upper back and between shoulder blades gave

me more pain relief than anything the pain doctor could do. (I just felt along

my facet joints and they are still tender but generally don't give me any

problems.)

Rochelle

>

> Has anyone had a facet rhizotomy. My pain management dr. is considering it

and it seems like a good thing. I'm at the point I'll try just about anything

to relieve the pain. But my surgeon said this is evasive and you might want to

reconsider.

>

> Anyone have any luck with rhizotomy?

> Thanks,

> Amy

>

Link to comment
Share on other sites

I have had the RF cauterization done three times so far.  Each time it helps

for about 6 glorious months.  6 months with only moderate pain is a gift from

God.  I recommend it to anyone who is eligible for it.  Know that there will

be increased pain in the area where they cauterize the nerves.  The doctors say

3-4 days but it has lasted as long as 6 weeks.  The pain is different and

bearable.

Joe Grant

From: rccoc1977 <rccoc1977@...>

Subject: Re: Rhizotomy??? Good/bad?

neck pain

Date: Thursday, January 28, 2010, 11:18 AM

 

Hi Amy,

A facet rhizotomy is considered for pain generated by one or more facet joints,

which are the paired joints at the back of each vertebra. This type of pain

would be felt as a tender spot over the particular painful joint along the side

of the neck (a little closer to rear of neck-your pain doctor has probably

pressed on them to see if they are tender). This type of pain also refers pain

(depending on the level of the painful joint) to the back of the neck(higher to

middle cervical vertebra), shoulder blade areas(lower cervical vertebra) and

back of head-(higher cervical vertebra))

The facet rhizotomy itself involves inserting a special needle (attached to

electrical current)close to the (medial)nerve that comes out of the joint. The

location is checked by xray, then steroid and anesthetic is released, and then

the electrical current is turned on to fry the nerve. The nerve dies back but

not permanently. Pain relief can last for many months to a year and a half

depending on when the nerve grows back.

Prior to doing the facet rhizotomy, the pain doctor should have done the

specific facet joint injections (close but not usually directly into the joint)

and you should have gotten pain relief.

The nerve that the pain doctor is trying to fry contains sensory nerves coming

from the joint so damaging them relieves the pain, but also the nerve bundle

contains motor nerves that control the little muscles (multifidous) that

stabilize the vertebra. I don't know how these " needle jockeys " know they are

getting the sensory nerves without damaging the motor nerves also. I've read

that one of the ways they know they got the right nerve is that the little

muscles at that point stop working (by emg test). My pain doctor told me not to

worry because he could get the sensory nerves only. I actually think he lied

because as far as I can tell motor and sensory neurons come bundled together in

the medial nerve. Anyway apparently, if you just do rhozotomy on one or at most

3 facet joints (only one side?)in the neck, instability isn't a problem because

there is a lot of overlap in the muscles so others can take over. If rhizotomy

is done in the lower back

instability can be a problem.

I have had facet rhizotomy done for painful facet joints but I didn't have pain

relief because as it turned out my pain, in spite of advanced arthritic changes

throughout my cervical spine, stemmed from my poor posture all along. Fixing my

posture and strengthening muscles in upper back and between shoulder blades gave

me more pain relief than anything the pain doctor could do. (I just felt along

my facet joints and they are still tender but generally don't give me any

problems.)

Rochelle

>

> Has anyone had a facet rhizotomy. My pain management dr. is considering it

and it seems like a good thing. I'm at the point I'll try just about anything

to relieve the pain. But my surgeon said this is evasive and you might want to

reconsider.

>

> Anyone have any luck with rhizotomy?

> Thanks,

> Amy

>

Link to comment
Share on other sites

I have had 2 done in my neck . one lasted about 14 months , the other about a

month . Fianally did fusion and have been good for 5 yrs now.

From: rccoc1977 <rccoc1977 (DOT) com>

Subject: [PainInTheNeck- Back] Re: Rhizotomy??? Good/bad?

PainInTheNeck- Back@groups .com

Date: Thursday, January 28, 2010, 11:18 AM

 

Hi Amy,

A facet rhizotomy is considered for pain generated by one or more facet joints,

which are the paired joints at the back of each vertebra. This type of pain

would be felt as a tender spot over the particular painful joint along the side

of the neck (a little closer to rear of neck-your pain doctor has probably

pressed on them to see if they are tender). This type of pain also refers pain

(depending on the level of the painful joint) to the back of the neck(higher to

middle cervical vertebra), shoulder blade areas(lower cervical vertebra) and

back of head-(higher cervical vertebra))

The facet rhizotomy itself involves inserting a special needle (attached to

electrical current)close to the (medial)nerve that comes out of the joint. The

location is checked by xray, then steroid and anesthetic is released, and then

the electrical current is turned on to fry the nerve. The nerve dies back but

not permanently. Pain relief can last for many months to a year and a half

depending on when the nerve grows back.

Prior to doing the facet rhizotomy, the pain doctor should have done the

specific facet joint injections (close but not usually directly into the joint)

and you should have gotten pain relief.

The nerve that the pain doctor is trying to fry contains sensory nerves coming

from the joint so damaging them relieves the pain, but also the nerve bundle

contains motor nerves that control the little muscles (multifidous) that

stabilize the vertebra. I don't know how these " needle jockeys " know they are

getting the sensory nerves without damaging the motor nerves also. I've read

that one of the ways they know they got the right nerve is that the little

muscles at that point stop working (by emg test). My pain doctor told me not to

worry because he could get the sensory nerves only. I actually think he lied

because as far as I can tell motor and sensory neurons come bundled together in

the medial nerve. Anyway apparently, if you just do rhozotomy on one or at most

3 facet joints (only one side?)in the neck, instability isn't a problem because

there is a lot of overlap in the muscles so others can take over. If rhizotomy

is done in the lower back

instability can be a problem.

I have had facet rhizotomy done for painful facet joints but I didn't have pain

relief because as it turned out my pain, in spite of advanced arthritic changes

throughout my cervical spine, stemmed from my poor posture all along. Fixing my

posture and strengthening muscles in upper back and between shoulder blades gave

me more pain relief than anything the pain doctor could do. (I just felt along

my facet joints and they are still tender but generally don't give me any

problems.)

Rochelle

>

> Has anyone had a facet rhizotomy. My pain management dr. is considering it

and it seems like a good thing. I'm at the point I'll try just about anything

to relieve the pain. But my surgeon said this is evasive and you might want to

reconsider.

>

> Anyone have any luck with rhizotomy?

> Thanks,

> Amy

>

Link to comment
Share on other sites

I have had 2 done in my neck . one lasted about 14 months , the other about a

month . Fianally did fusion and have been good for 5 yrs now.

From: rccoc1977 <rccoc1977 (DOT) com>

Subject: [PainInTheNeck- Back] Re: Rhizotomy??? Good/bad?

PainInTheNeck- Back@groups .com

Date: Thursday, January 28, 2010, 11:18 AM

 

Hi Amy,

A facet rhizotomy is considered for pain generated by one or more facet joints,

which are the paired joints at the back of each vertebra. This type of pain

would be felt as a tender spot over the particular painful joint along the side

of the neck (a little closer to rear of neck-your pain doctor has probably

pressed on them to see if they are tender). This type of pain also refers pain

(depending on the level of the painful joint) to the back of the neck(higher to

middle cervical vertebra), shoulder blade areas(lower cervical vertebra) and

back of head-(higher cervical vertebra))

The facet rhizotomy itself involves inserting a special needle (attached to

electrical current)close to the (medial)nerve that comes out of the joint. The

location is checked by xray, then steroid and anesthetic is released, and then

the electrical current is turned on to fry the nerve. The nerve dies back but

not permanently. Pain relief can last for many months to a year and a half

depending on when the nerve grows back.

Prior to doing the facet rhizotomy, the pain doctor should have done the

specific facet joint injections (close but not usually directly into the joint)

and you should have gotten pain relief.

The nerve that the pain doctor is trying to fry contains sensory nerves coming

from the joint so damaging them relieves the pain, but also the nerve bundle

contains motor nerves that control the little muscles (multifidous) that

stabilize the vertebra. I don't know how these " needle jockeys " know they are

getting the sensory nerves without damaging the motor nerves also. I've read

that one of the ways they know they got the right nerve is that the little

muscles at that point stop working (by emg test). My pain doctor told me not to

worry because he could get the sensory nerves only. I actually think he lied

because as far as I can tell motor and sensory neurons come bundled together in

the medial nerve. Anyway apparently, if you just do rhozotomy on one or at most

3 facet joints (only one side?)in the neck, instability isn't a problem because

there is a lot of overlap in the muscles so others can take over. If rhizotomy

is done in the lower back

instability can be a problem.

I have had facet rhizotomy done for painful facet joints but I didn't have pain

relief because as it turned out my pain, in spite of advanced arthritic changes

throughout my cervical spine, stemmed from my poor posture all along. Fixing my

posture and strengthening muscles in upper back and between shoulder blades gave

me more pain relief than anything the pain doctor could do. (I just felt along

my facet joints and they are still tender but generally don't give me any

problems.)

Rochelle

>

> Has anyone had a facet rhizotomy. My pain management dr. is considering it

and it seems like a good thing. I'm at the point I'll try just about anything

to relieve the pain. But my surgeon said this is evasive and you might want to

reconsider.

>

> Anyone have any luck with rhizotomy?

> Thanks,

> Amy

>

Link to comment
Share on other sites

I have had 2 done in my neck . one lasted about 14 months , the other about a

month . Fianally did fusion and have been good for 5 yrs now.

From: rccoc1977 <rccoc1977 (DOT) com>

Subject: [PainInTheNeck- Back] Re: Rhizotomy??? Good/bad?

PainInTheNeck- Back@groups .com

Date: Thursday, January 28, 2010, 11:18 AM

 

Hi Amy,

A facet rhizotomy is considered for pain generated by one or more facet joints,

which are the paired joints at the back of each vertebra. This type of pain

would be felt as a tender spot over the particular painful joint along the side

of the neck (a little closer to rear of neck-your pain doctor has probably

pressed on them to see if they are tender). This type of pain also refers pain

(depending on the level of the painful joint) to the back of the neck(higher to

middle cervical vertebra), shoulder blade areas(lower cervical vertebra) and

back of head-(higher cervical vertebra))

The facet rhizotomy itself involves inserting a special needle (attached to

electrical current)close to the (medial)nerve that comes out of the joint. The

location is checked by xray, then steroid and anesthetic is released, and then

the electrical current is turned on to fry the nerve. The nerve dies back but

not permanently. Pain relief can last for many months to a year and a half

depending on when the nerve grows back.

Prior to doing the facet rhizotomy, the pain doctor should have done the

specific facet joint injections (close but not usually directly into the joint)

and you should have gotten pain relief.

The nerve that the pain doctor is trying to fry contains sensory nerves coming

from the joint so damaging them relieves the pain, but also the nerve bundle

contains motor nerves that control the little muscles (multifidous) that

stabilize the vertebra. I don't know how these " needle jockeys " know they are

getting the sensory nerves without damaging the motor nerves also. I've read

that one of the ways they know they got the right nerve is that the little

muscles at that point stop working (by emg test). My pain doctor told me not to

worry because he could get the sensory nerves only. I actually think he lied

because as far as I can tell motor and sensory neurons come bundled together in

the medial nerve. Anyway apparently, if you just do rhozotomy on one or at most

3 facet joints (only one side?)in the neck, instability isn't a problem because

there is a lot of overlap in the muscles so others can take over. If rhizotomy

is done in the lower back

instability can be a problem.

I have had facet rhizotomy done for painful facet joints but I didn't have pain

relief because as it turned out my pain, in spite of advanced arthritic changes

throughout my cervical spine, stemmed from my poor posture all along. Fixing my

posture and strengthening muscles in upper back and between shoulder blades gave

me more pain relief than anything the pain doctor could do. (I just felt along

my facet joints and they are still tender but generally don't give me any

problems.)

Rochelle

>

> Has anyone had a facet rhizotomy. My pain management dr. is considering it

and it seems like a good thing. I'm at the point I'll try just about anything

to relieve the pain. But my surgeon said this is evasive and you might want to

reconsider.

>

> Anyone have any luck with rhizotomy?

> Thanks,

> Amy

>

Link to comment
Share on other sites

I have had 2 done in my neck . one lasted about 14 months , the other about a

month . Fianally did fusion and have been good for 5 yrs now.

From: rccoc1977 <rccoc1977 (DOT) com>

Subject: [PainInTheNeck- Back] Re: Rhizotomy??? Good/bad?

PainInTheNeck- Back@groups .com

Date: Thursday, January 28, 2010, 11:18 AM

 

Hi Amy,

A facet rhizotomy is considered for pain generated by one or more facet joints,

which are the paired joints at the back of each vertebra. This type of pain

would be felt as a tender spot over the particular painful joint along the side

of the neck (a little closer to rear of neck-your pain doctor has probably

pressed on them to see if they are tender). This type of pain also refers pain

(depending on the level of the painful joint) to the back of the neck(higher to

middle cervical vertebra), shoulder blade areas(lower cervical vertebra) and

back of head-(higher cervical vertebra))

The facet rhizotomy itself involves inserting a special needle (attached to

electrical current)close to the (medial)nerve that comes out of the joint. The

location is checked by xray, then steroid and anesthetic is released, and then

the electrical current is turned on to fry the nerve. The nerve dies back but

not permanently. Pain relief can last for many months to a year and a half

depending on when the nerve grows back.

Prior to doing the facet rhizotomy, the pain doctor should have done the

specific facet joint injections (close but not usually directly into the joint)

and you should have gotten pain relief.

The nerve that the pain doctor is trying to fry contains sensory nerves coming

from the joint so damaging them relieves the pain, but also the nerve bundle

contains motor nerves that control the little muscles (multifidous) that

stabilize the vertebra. I don't know how these " needle jockeys " know they are

getting the sensory nerves without damaging the motor nerves also. I've read

that one of the ways they know they got the right nerve is that the little

muscles at that point stop working (by emg test). My pain doctor told me not to

worry because he could get the sensory nerves only. I actually think he lied

because as far as I can tell motor and sensory neurons come bundled together in

the medial nerve. Anyway apparently, if you just do rhozotomy on one or at most

3 facet joints (only one side?)in the neck, instability isn't a problem because

there is a lot of overlap in the muscles so others can take over. If rhizotomy

is done in the lower back

instability can be a problem.

I have had facet rhizotomy done for painful facet joints but I didn't have pain

relief because as it turned out my pain, in spite of advanced arthritic changes

throughout my cervical spine, stemmed from my poor posture all along. Fixing my

posture and strengthening muscles in upper back and between shoulder blades gave

me more pain relief than anything the pain doctor could do. (I just felt along

my facet joints and they are still tender but generally don't give me any

problems.)

Rochelle

>

> Has anyone had a facet rhizotomy. My pain management dr. is considering it

and it seems like a good thing. I'm at the point I'll try just about anything

to relieve the pain. But my surgeon said this is evasive and you might want to

reconsider.

>

> Anyone have any luck with rhizotomy?

> Thanks,

> Amy

>

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Thank you everyone! Rochelle & smokie ¡V thanks for the info. And Joe, your

words are very encouraging.

I¡¦m not sure what my next steps will be. This has been going on for 7 years

now (from a car accident) and doctors are trying to figure out why the pain is

so severe. I¡¦m at the point to try anything at this point. I have 2 bulging

and 2 herniated disks but none are really ¡¥severely damaged¡¦ from an MRI or

EMG point of view. I¡¦ve had the facets in the past and I finally have a good

doctor who I trust to try the facets again and maybe the rhizotomy. My surgeon,

cautioning me on the rhizotomy, said that because there are 4 damaged discs we

can¡¦t really determine which 1 (if only 1) is causing the pain¡K we can¡¦t

replace all of em! So, he¡¦s going to try, as a last resort if I don¡¦t get any

relief from the facets, etc. he¡¦s going to do a discogram to determine which

disk(s) are the real problem. And if it¡¦s just one, we¡¦ll remove that one.

So, wish me luck as I continue forward on my journey.

All I can say is I completely empathize with everyone experiencing such horrible

pain and feeling so down and depressed. Pain is EXHAUSTING! To say the least.

I¡¦m curious to see, smokie, how your fusion went as well. Anyone have a

discogram?

Thank you all for your support and understanding ļ

Amy

>

> Has anyone had a facet rhizotomy. My pain management dr. is considering it

and it seems like a good thing. I'm at the point I'll try just about anything

to relieve the pain. But my surgeon said this is evasive and you might want to

reconsider.

>

> Anyone have any luck with rhizotomy?

> Thanks,

> Amy

>

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amy, best wishes and prayers for a fantastic outcome and solution to your pain.

hugs, wyld

From: Amy <newt2456@...>

Subject: Re: Rhizotomy??? Good/bad?

neck pain

Date: Thursday, January 28, 2010, 11:46 AM

 

Thank you everyone! Rochelle & smokie ¡V thanks for the info. And Joe, your

words are very encouraging.

I¡¦m not sure what my next steps will be. This has been going on for 7 years

now (from a car accident) and doctors are trying to figure out why the pain is

so severe. I¡¦m at the point to try anything at this point. I have 2 bulging

and 2 herniated disks but none are really ¡¥severely damaged¡¦ from an MRI

or EMG point of view. I¡¦ve had the facets in the past and I finally have a

good doctor who I trust to try the facets again and maybe the rhizotomy. My

surgeon, cautioning me on the rhizotomy, said that because there are 4 damaged

discs we can¡¦t really determine which 1 (if only 1) is causing the pain¡K we

can¡¦t replace all of em! So, he¡¦s going to try, as a last resort if I

don¡¦t get any relief from the facets, etc. he¡¦s going to do a discogram to

determine which disk(s) are the real problem. And if it¡¦s just one, we¡¦ll

remove that one. So, wish me luck as I continue forward on my journey.

All I can say is I completely empathize with everyone experiencing such horrible

pain and feeling so down and depressed. Pain is EXHAUSTING! To say the least.

I¡¦m curious to see, smokie, how your fusion went as well. Anyone have a

discogram?

Thank you all for your support and understanding ļ

Amy

>

> Has anyone had a facet rhizotomy. My pain management dr. is considering it and

it seems like a good thing. I'm at the point I'll try just about anything to

relieve the pain. But my surgeon said this is evasive and you might want to

reconsider.

>

> Anyone have any luck with rhizotomy?

> Thanks,

> Amy

>

Link to comment
Share on other sites

amy, best wishes and prayers for a fantastic outcome and solution to your pain.

hugs, wyld

From: Amy <newt2456@...>

Subject: Re: Rhizotomy??? Good/bad?

neck pain

Date: Thursday, January 28, 2010, 11:46 AM

 

Thank you everyone! Rochelle & smokie ¡V thanks for the info. And Joe, your

words are very encouraging.

I¡¦m not sure what my next steps will be. This has been going on for 7 years

now (from a car accident) and doctors are trying to figure out why the pain is

so severe. I¡¦m at the point to try anything at this point. I have 2 bulging

and 2 herniated disks but none are really ¡¥severely damaged¡¦ from an MRI

or EMG point of view. I¡¦ve had the facets in the past and I finally have a

good doctor who I trust to try the facets again and maybe the rhizotomy. My

surgeon, cautioning me on the rhizotomy, said that because there are 4 damaged

discs we can¡¦t really determine which 1 (if only 1) is causing the pain¡K we

can¡¦t replace all of em! So, he¡¦s going to try, as a last resort if I

don¡¦t get any relief from the facets, etc. he¡¦s going to do a discogram to

determine which disk(s) are the real problem. And if it¡¦s just one, we¡¦ll

remove that one. So, wish me luck as I continue forward on my journey.

All I can say is I completely empathize with everyone experiencing such horrible

pain and feeling so down and depressed. Pain is EXHAUSTING! To say the least.

I¡¦m curious to see, smokie, how your fusion went as well. Anyone have a

discogram?

Thank you all for your support and understanding ļ

Amy

>

> Has anyone had a facet rhizotomy. My pain management dr. is considering it and

it seems like a good thing. I'm at the point I'll try just about anything to

relieve the pain. But my surgeon said this is evasive and you might want to

reconsider.

>

> Anyone have any luck with rhizotomy?

> Thanks,

> Amy

>

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