What Happens During Cervical Rhizotomy?

Cervical rhizotomy is a surgical procedure. It is a procedure that has to be performed by a medical doctor, although a chiropractor may be on the treatment team. 

Cervical rhizotomy is usually offered as day surgery. You go in for the procedure, and then a friend or family member drives you home after you get out of the recovery room.

Just about the first thing that will happen when you get into the surgery room is you will be given an IV port. This is just a precaution in case you are one of a very, very few people who has an allergic reaction to lidocaine, the medication used to numb the neck before the surgeon introduces the radiofrequency ablation needle.

Then, using a fluoroscope so he or she has an image of the bones in your neck, the surgeon introduces a needle at the edge of the nerve that is conducting pain messages to your brain. This is typically a 22-gauge needle, the same size needle. It's not as thick as the used for your IV (which is typically 18- or 20-gauge). It's about the same size needle as is used for a flu shot.

You may experience a buzzing, tingling, or vibrating sensation as the doctor confirms that the needle has been placed at the correct nerve. Then for 1 to 2 minutes the doctor "zaps" the nerve so the transmission of pain signals stops. Sometimes the doctor will also inject a small amount of a steroid injection into the site of the procedure to prevent swelling and inflammation. This is the "paraspinal injection."

And that's it. Usually pain relief begins about 15 minutes after the procedure, but sometimes it takes about a week. But it's important to understand that you almost certainly won't get 100% pain relief rom the procedure.

Typically, cervical rhizotomy leaves the patient with less pain, not no pain. It may be possible to function with less pain medication, and it may be possible to tolerate more activity or to move the neck through a greater range of motion. 

It is also vital to understand that cervical rhizotomy offers relief, not cure. Pain usually begins to come back in about 3 months, and after 4 months, most people are ready for another round of treatment.

The nerves that are numbed by radiofrequency ablation typically regenerate themselves in just a few months. During those 3 to 4 months, however, you may experience sufficient reduction of pain that you just do not remember feeling as good--losing pains that you had even forgotten you had.