Lumbar Facet Joint Rhizotomy L4/L5
 

I'm a fit 45 yr old male scheduled for a surgical Lumbar Facet Joint Rhizotomy in L4/L5 next month and not sure if I should cancel or go through with it.

I've had a microdiscectomy surgery in 2010 after a severe herniation. 20% to 30% of the disk was removed and I have been fine for 2 years until recently.

I had a facet block shots and felt relief from the joint pain, but it was temporary...only lasted a day or two and then the pain slowly began to ramp up over several days.

Due to the relief I experienced with the facet block shots...the surgeon said I would be a good candidate for the permanent Rhizotomy. Some people may have had the temporary Rhizotomy done with needles...the one he suggested for me is under the knife and will result in a permanent (not temporary) loss of the nerves in that joint.

The surgeon said that he's only had 2 people not experience relief from this procedure and he does about 4 to 5 of these a month for years.

I'm on the fence as to whether or not to cancel the procedure and live with the pain or go through with it and see if it helps at all.

Part of me is reluctant to do it just because I don't like the idea of losing the use of nerves and no one wants a surgery.

Every other day...I feel good and want to cancel and then the next day...not so good and want to try the surgery.

I need help from anyone who has had this procedure done...any comments of your experiences (good or bad) would be greatly welcomed and appreciated.

Thanks!

Ummm - I hate to tell you this, but Rhizotomy isn't permanent. Nerves grow back. And they grow back at the AVERAGE rate of one inch per month. Some grow faster, some slower. So I don't know how he said this was permanent.

I had Rhizotomy done -- it didn't work. I still have the pain like I had before. The doc used the Fluroscope so he know which nerve he was doing so there wasn't any screw up. It just plain didn't work.

But anyway -- the procedure itself was a snap. Just a little discomfort the day after. I just put some ice on it, and I was fine. But again, this isn't permanent.

Best of luck & God bless. Hugs, Lee ;)

Lee, Thanks for the info. I have spoken with a friend who had it done as well and there were two procedures explained to me...one was where they "zap" the nerves through a long needle where the nerve may grow back which was not surgical and the patient was awake which results in temporary relief until the nerve grows back.

The other procedure was described as two small incisions on either side, muscle dilation, and flouroscope tube to view the nerve and permanently severing. No mention of regrowth was brought up. It was presented as more "permanent" than the needle procedure where they ask you...does that hurt? Does that feel better? Which is what my friend had done to her.

I guess I have some more questions now.

Thanks for your response!

Hi Geno
 

Welcome to Neuro Talk. I myself didn't have the facet blocks. I do know they are temporary, even the surgery for it. I would seek another opinion on the whole thing before submitting to it. Just personal opinion. I had ketamine infusions for cervial spine, and that helped for about 3 months. Question everything with your doctor. Ask all quesitons, including asking him about the permanence of this proceedure. Don't hesitate to google up the information. Much is on line about that block and others that may be offered to you. I don't blame you for not wanting more surgery. None of us do, thats for sure.
Keep in touch and we will be here for you, no matter what you decide to do. It is a hard decision, especially when no guarantees can be offered. I wish you all the best. ginnie:hug:

Geno ~ I just did some research, and you're RIGHT. ;) The PERMANENT Rhizotomy is called Selective Dorsal Rhizotomy, while the temporary kind is called Facet Rhizotomy. Funny tho, that where I hurt, I didn't have facets! :confused: Strange. But oh well. LOL

Thanks for pointing out my mistake. I want to give people the correct information! Take care & God bless. Hugs, Lee :)

Has anyone had this done before that can share their experience...good or bad? Anyone had a permanent Ryzotomy out there? I'm running out of time. Not sure what to do.:confused:

I would go for it. Sorry I didn't reply sooner, but I WOULD have it done if you're in excruciating pain! I would have if it had been offered! God bless! Hugs, Lee

Well, I went for the surgery. It felt like someone took a bat to my low back after the hospital meds wore off and the morning after I felt like I had a severe bruise. The ice and pain meds help tremendously. I'm going on day 4 and feeling pretty good, getting up and about and able to walk around gingerly at first and more normal today. Aside from the bruised feeling...the low back pain in the joint seems to be gone, but it's still hard to tell this early. I don't notice any loss of balance after having the proprioceptive nerves cauterized...can't even tell at all so far. I'll share more later.

It's now 6 weeks since I've had the rhizotomy and I'm feeling much better, but still have swelling in the muscle tissue that I'm still icing twice a day. The problem still exists with my L4/L5 disk having zero fluid and 20% to 30% of it being removed thus it's riding lower than it should be so I still am unable to run or lift heavy weights without further stressing that disk. So I baby my disk as much as I can and treat it with great care.

Overall the pain from the facets pinching the nerves has been alleviated after having the nerves cauterized and I'm able to get on with life relatively well, but as I stated earlier...I can't lift anything heavy or run. Even stepping down hard can be felt easily and quickly regretted later. I almost need to continue to walk gingerly as if sneaking around some days.

I do utilize a back swing regularly to get the pressure off the disk for 5 to 15 minutes a day. I probably should do more. I think it helps.

I'd recommend this procedure to anyone who has compromised their disk and find that their vertebrae are closer than they should be, however, it's not a total fix. Unless the disk is sitting at the correct height there will always be a need to treat the disk with the utmost care.

I think it's worth it if it buys more time before I have to face the music with a spinal fusion...which I'm absolutely dreading getting.

Hey Geno ~ I'm SO glad to hear you still have some relief from the procedure! That's great and lets hope it continues for a good long time. :D It's great to hear good news once in awhile.

Well, NOT having the fusion can be done. No one would lay a hand on me due to previous surgeries, and also due to osteoporosis. So I was left high & dry. I went to 3 different heads of Neurology at 3 LARGE hospitals here in Michigan, and nope - they wouldn't do it. Don't get me wrong, I was glad -- but I was kinda hoping for some kind of relief too. LOL

I hope YOU don't have to have fusion - and I hope YOU get 3 opinions from different surgeons! Don't take one surgeons opinion, that's for sure. ;)

Again, thanks Geno for coming back and letting us know how you're doing! We REALLY appreciate this -- you've helped a LOT of people by doing this! God bless and please take care. Hugs, Lee :)