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Spinal Roundtable Discuss facet rhizotomy in the General Discussion forums; I am looking for information on facet rhizotomy. I did a search and saw that Tony had a good experience ...

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  #1  
Old 01-12-2005, 12:11 PM
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I am looking for information on facet rhizotomy. I did a search and saw that Tony had a good experience with it, but there is very little info other than that. I have posted this on the other forum also to cover my bases and get as much info as possible in a short time as I need to make a decision quickly and plan for down time.
Has anyone had a facet rhizotomy done? I have researched it online, but would like some first hand info. I have read to expect an increase in pain levels for a few weeks after - how much of an increase? Will I be unable to work the minimum hours I am currently working? Did the rhizotomy help you? And if it did help, how long did it last? Were there any complications or side effects from the procedure? How painful was the procedure? Did you have facet injections done first and if so, were they considered positive and in what way? (In my case, the facet injections gave me some immediate temporary relief - about an hour or two - but no relief after that). How much did the procedure cost? If it doesn't work, will it cause more damage or pain than I already have? Any info would be greatly appreciated, as my surgeon called yesterday and wants me to go to Philadelphia for a rhizotomy. It is quite a distance, but he thinks this guy is the best - so, I would definteley rather travel and have it done by someone with experience than to go locally just to avoid the travel pain. Also need to find out if insurance is going to cover this or not. "Burning nerves" sounds scary and painful to me - but staying in pain 24/7 is even more scary and painful.
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May 2002 Degenerated disks at L3-4,L4-5, and L5-S1.
Feb 2004- Flexicore ADR - L5-S1
Jan 2005 - pinching pain in back and leg weakness is gone, but severe nerve pain in hips,legs, low back and backside has not improved. May 2006 Nucleoplasty L3-4 a
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  #2  
Old 01-12-2005, 02:47 PM
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tisury,
My unqualified hack opinion is that there are few risks with this procedure when done by an experienced doctor, and since this procedure does not alter the mechanics or structure of your spine, it is usually worth the low risks. Your doctor most likely feels that your pain is primarily from your facets (the facet injections you had were diagnostic; giving your doctor information as to what is causing your primary pain). The rhizotomy may really help you. If it does greatly improve your primary pain, then that will help to define your primary pain generator as non-discogenic. You want the most accurate definition of what is causing your back problems, so this may add another piece to the puzzle. My opinion on rhizotomy is not based primarily on published medical findings, but on anecdotal information gathered from conversations with doctors and most importantly, fellow patients. The qualifications and experience of the doctor performing the procedure seems to be the key here.
Here's to pain relief,
Jeff
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Old 01-12-2005, 02:48 PM
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Ms. Mary Claire Walsh
SpineUniverse Staff Writer
Said


What is facet rhizotomy?
The goal of a facet rhizotomy is to provide pain relief by "shutting off" the pain signals that the joints send to the brain. The pain relief experienced by most patients who have this procedure lasts months or even years.

How it is done
Patients who are candidates for rhizotomy typically have undergone several facet joint injections to verify the source and exact location of their pain. Using a local anesthetic and x-ray guidance, a needle with an electrode at the tip is placed along side the small nerves to the facet joint. The electrode is then heated, with a technology called radiofrequency, to deaden these nerves that carry pain signals to the brain.

Serious complications with facet rhizotomies are rare. A new technique using pulsed radiofrequency does not actually burn the nerve, but appears to stun the nerve. This technique appears to be even safer than the regular radiofrequency technique, but does seem to have the drawback of not lasting quite as long. Some specialists (such as the author) prefer to use the pulsed technique in higher risk areas such as the neck.

The procedure takes about 30-60 minutes. Afterwards, patients are monitored for a short time before being released.


A link here with further info

http://www.spineuniverse.com/display...rticle200.html

Best
Alastair
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Old 01-14-2005, 08:31 AM
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Thanks Jeff and Alastair for your replies. I am leaning toward the thought that I have nothing to lose in trying it and hopefully something to gain. In my research, I have also read that RF is used for discogenic pain also. That has me a little confused. Will killing the nerves solve both facet joint irritation and disc irritation of the nerves or does it depend on where they insert the probe? Anyone know the answer to this one? I am still not totally convinced my pain is not discogenic, but then, I am not a doctor either. It appears from the number of responses that not alot of people have had this procedure done or else they just haven't been on lately. Again, thanks for your replies.
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May 2002 Degenerated disks at L3-4,L4-5, and L5-S1.
Feb 2004- Flexicore ADR - L5-S1
Jan 2005 - pinching pain in back and leg weakness is gone, but severe nerve pain in hips,legs, low back and backside has not improved. May 2006 Nucleoplasty L3-4 a
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Old 01-14-2005, 09:10 AM
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Just looking at what you say above, and the history that you put at the bottom of your posting I wonder if you have ever had Discogramme? That would solve most of your diagnostic problems and would tell you whether it definitely is disc related problems or problems relating to the nerves surrounding your disks.

There has not been the history of problems being solved by cutting the nerves which supply the facet joints. I was offered that procedure.

There is quite a lot of information regarding to facet joints on this web site. Please browse the FAQs

It sounds as if you need to get a Discogramme done and take matters from their.
Best wishes,
Alastair
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Old 01-15-2005, 12:17 AM
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Alastair,
Yes, I had 2 discograms done before my ADR. The first stated only L3-4 was positive. The ADR surgeon did not have alot of faith in the discograms done at the 1st facility and did not feel the results matched the clincial findings, so he sent me to Maryland for a second one. The second one said only L5-S1 was a pain generator. ADR was done at L5-S1 only. I wish I would have pushed for a 3rd one to confirm the findings, but he seemed confident that it was ONLY L5-S1. He says he still does not think another level is involved. I can't imagine if this RF fails, that he will have any other choice other than to order another discogram since nothing else is working. I have feared that another disk was involved for quite some tme now........but I am not a doctor. I hope he is right and this works. But from what I have read, if it is the facets, relief may be temporary and in the long run, the only way to fix may be to fuse that level to stop the motion. I can't imagine that after going through all this to preserve the motion (ADR), that a fusion may be the only solution to the pain. Or possibly Dynseys, but that is still in trials also. Right now, I just need some answers. What will be, will be, I guess.
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May 2002 Degenerated disks at L3-4,L4-5, and L5-S1.
Feb 2004- Flexicore ADR - L5-S1
Jan 2005 - pinching pain in back and leg weakness is gone, but severe nerve pain in hips,legs, low back and backside has not improved. May 2006 Nucleoplasty L3-4 a
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  #7  
Old 01-15-2005, 09:00 AM
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Hi tisury,
If you have read about facets here,you will know its hard to be positive about them causing the problems. Even if facet joint injections ease matters its far from a definite YES.

Facets usually trouble people with a twisting and bending sideways motion - -- - do you relate to that?

I live in the UK so know nothing about your Drs there. Dr Yue seems very well informed and has visited Europe. Look at the new question and answer section and you will see those surgeons at TBI say a discogramme is a good tool. I wonder if your prevoius spine people were not experts at this?

Its a good idea to see what happens with the direction you are going. Its not all that invasive. Do come back and let us know how you get on if you have this.
Best wishes
Alastair
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ADR Munich 26th July 2002 L5/S1. Aged 75 now
Your best asset is your health
My story is here
http://www.adrsupport.org/alastair.html
Thank goodness for Dr Zeegers I am painfree
I am here to help,I live in the UK


I now run the UK spine site and can be contacted at

www.adrsupportuk.com/
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Old 01-16-2005, 08:18 PM
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Since my ADR, there is really no position that I move my body - forward, backward, sideways, twisting - that causes any immediate pain in my back. There are positions that definetely increase the leg and low back burning: and if I do alot one day, this pain will escalate for the next few days. I very seldom have anything............sudden (for lack of a better description). It is always the same, this horrible burning, aching, relentless pain 24/7 whcih is somewhat better in the morning. Occasionally, I will get what feels like muscle spasms in my lower and middle back -out about an inch or two from the center of my spine.
I don't have the catching or locking up sensation that I have read is sometimes related to facet problems. But the more I read, the more I think there is no typical pattern to facet syndrome.
I do believe I will go ahead with the rhizotomy. I am just waiting for them to call to schedule a time. Hopefully soon. My main concern is that I may be killing the messenger (the nerves) instead of fixing the underlying problem with this procedure. Right now I desperately need some kind of relief from this pain and I don't think there is a lot of risk involved, so hopefully, I have nothing to lose and possibly something to gain by trying it. I will definetely let you know how it goes. Thanks again for all your help.
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May 2002 Degenerated disks at L3-4,L4-5, and L5-S1.
Feb 2004- Flexicore ADR - L5-S1
Jan 2005 - pinching pain in back and leg weakness is gone, but severe nerve pain in hips,legs, low back and backside has not improved. May 2006 Nucleoplasty L3-4 a
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  #9  
Old 01-17-2005, 08:53 AM
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Folks, these may be a good questions to hone into 1 or 2 questions for the next doctor Q & A ...especially since the topic is not well-published?
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Old 01-21-2005, 09:04 AM
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Hi there.
I just had this procedure last Thursday. C 5-6
Hasn't seemed to help me yet. I am not sure why although I have other levels too that are "messed up".
It didn't hurt at all. Swelling afterwards but used ice and felt ok.Ice seems to always help my neck some. It took 30 minutes all done under fluoroscopy. Dr. gave me pics of procedure.
Not sure what they are going to do next.
Hope some of this helps.
Thanks,
Sherree
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