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Cervical rhizotomy, also known as cervical facet rhizotomy is a simple medical procedure used to stop chronic neck pain. Sometimes accompanied by a similar treatment known as paraspinal injection, this procedure is performed by a physician specializing in a field known as neurointerventional surgery, but the procedure does not require "surgery" in the traditional sense.
A needle is inserted into the neck to a facet, or point, on the spine in the neck that has previously been found to be generating pain. The needle generates radiofrequency radiation that heats the nerve and deadens it, blocking pain signals until the nerve recovers, usually keeping the patient pain-free for 3 to 6 months.
Who Is a Likely Candidate for Cervical Rhizotomy?
We don't usually think of the neck as containing joints, but 24 of 33 vertebrae that make up the spine are "articulating," capable of bending, slightly, so the neck and the upper body can move. The 9 vertebrae in the sacrum and the coccyx, or "tailbone," are imbedded in bone and fixed so that they do not move with the motion of the body.
Like joints elsewhere in the body, the joints in the spine can slowly wear out. The damage to the joint does not cause pain, however, until it begins to affect not just the cartilage that connects the spine to muscles but the bone itself. The nerves are in the bone, not in the cartilage. Damage to a joint is likely to be very advanced before it causes pain, and the things one might do to keep a joint in good condition are generally too late to prevent neck pain.
When the deteriorating joints are located in the cervical spine, that is in the vertebrae of the neck, severe joint damage can present a baffling combination of symptoms. Symptoms of facet joint arthritis of the cervical spine include:
- Neck pain. Neck pain is usually worse when nodding, moving the head from side to side, or bowing.
- Headaches. These headaches usually occur at the sides of the head.
- Muscle spasms in the neck. Usually muscle spasms are focal rather than "all over" the neck.
Pain Relief, Rather than Reconstruction
Cervical rhizotomy is all about relieving pain, rather than repairing the joint. When the effects of the procedure wear off, it has to be repeated. On the other hand, cervical rhizotomy can relieve pain that isn't necessarily caused by deterioration of the joint. It might be used to buy time so a deteriorated disk can heal, or it might even be used to control referred pain caused by procedures one ordinarily would not associate with neck pain, such as gall bladder surgery and dental work.