A Stronger, More Durable Solution for Chronic Low Back Pain
If you’ve had radiofrequency ablation (RFA) and your back pain returned—or never fully went away—it may be time for something more definitive. A surgical lumbar facet rhizotomy, performed using a trephine and bipolar cautery, is designed to provide long-lasting, often permanent relief from facet joint pain.
What Is a Surgical Lumbar Rhizotomy?
Surgical lumbar facet rhizotomy is a highly targeted, minimally invasive procedure that disables the medial branch nerves responsible for facet-mediated back pain. Unlike standard RFA, which uses heat alone, this technique combines:
- A trephine to mechanically access and disrupt the nerve
- Bipolar cautery to fully ablate the nerve with controlled thermal energy
This approach is ideal for patients with:
- Chronic low back pain due to facet arthropathy or spinal degeneration
- Short-lived or incomplete relief from prior RFA
- A desire for a longer-term solution that doesn’t rely on injections or repeat procedures
Why We Go Beyond RFA
RFA can be effective, but it sometimes falls short because:
- The nerve lesions are small and may not fully eliminate the pain signal
- The medial branch nerves can regrow over time
- Complex anatomy or post-surgical changes limit the effectiveness of needle-based heat lesions
By combining trephine dissection and bipolar cautery, we create a more complete and permanent ablation, reducing the likelihood of future pain.
Our Technique: Trephine + Bipolar Cautery
Our surgical rhizotomy method uses:
- A trephine to reach and mechanically disrupt the medial branch nerve at its origin along the facet joint
- Bipolar cautery to deliver precise, controlled energy and thermally ablate the nerve, all under real-time fluoroscopic guidance
This combination allows for a larger, more complete lesion and provides more durable results than traditional needle-based RFA.
What to Expect
- Outpatient procedure performed under local anesthesia with sedation
- Small incisions with fluoroscopic imaging for accuracy
- Return to light activity in 1–2 days
- Relief typically begins within 1–3 weeks and can be long-lasting or permanent
Is Surgical Rhizotomy Right for You?
You may be a good candidate if:
- You’ve been diagnosed with facet joint-related back pain
- You’ve had medial branch blocks or RFA with only short-term results
- You’re looking for a long-term solution to get off the injection cycle
- You’re searching for a spine specialist or back pain expert near you
FAQs
- Is this open surgery?
No. It’s a minimally invasive procedure performed through small incisions, typically as an outpatient.
- Why use both trephine and bipolar cautery?
The trephine ensures direct mechanical disruption of the nerve, and bipolar cautery adds precise, thermal ablation — offering a more complete and permanent result.
Talk to a Spine Specialist Near You
Stop chasing temporary relief. A surgical lumbar facet rhizotomy using trephine and bipolar cautery offers the long-term solution you’ve been looking for.
👉 Call today to schedule your consultation with a lumbar spine specialist near you and take the first step toward lasting pain relief.