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Rhizotomy Side Effects: Killing Off Important Stabilizers

POSTED ON IN Back/lumbar Latest News BY Chris Centeno

rhizotomy side effects

Radiofrequency ablation or RFA (also known as rhizotomy) has become a mainstay of low back pain treatment in the U.S. and elsewhere. However, what if the list of rhizotomy side effects held a secret that most patients never knew about nor were informed of as a possibility. What if everyone who got a successful RFA had this serious side effect and that will likely make them worse off in the long-run? Would as many patients sign up for this common procedure? Let me explain.

RFA or rhizotomy involves precisely placing a specialized needle near the nerve that takes pain signals from a painful low back facet joint. These joints can become painful when the patient’s low back discs begin to loose height and more wear and tear is experienced by these joints or when these joints are injured. The procedure works by the tip of the needle heating up, which literally burns the little nerve away (ablates or destroys it). While one function of the nerve is to take pain signals from the joint to the brain, another is to supply the important stabilizing muscles of the back known as multifidus. These little muscles are critical for normal back function, as they control the movement of one vertebra on another. When the nerve is ablated, these muscles suffer. How much can they get damaged by killing their nerve? The image above tells the story.

This image is from a patient we treated in Grand Cayman patient where we use our advanced cultured stem cell procedure at our our licensed site there). He’s had several RFAs on the right (left side of the picture above). The white dashed circles are around the multifidus compartment. The dark color is muscle, the white color is fat atrophy (meaning dead muscle). Notice how the circle on the left of the picture (right on the patient) is filled largely with white, which is muscle that has been killed off by the RFA. Compare this to the other side without the RFA which is still alive and dark. So while RFA took his pain away for 6-12 months at a time, it also set his back up to be unstable and unprotected. Will these muscles grow back? Unlikely in my experience.

The upshot? RFA is a destructive procedure that we AVOID in our practice. It’s the opposite of a regenerative medicine procedure. Today, given how well platelet rich plasma or stem cells work in these small joints, there’s simply no reason to destroy nerves in a patient’s low back. Hopefully, this is the beginning of the end of this procedure and the next generation of doctors will look back in horror and say, “What were they thinking?”

 

    comments

    BL says

    I spoke to a rep for "Coolief" and asked if, for the knee, whether it effects motor function and I was told no, it only affects sensory nerves. Do you think that is correct??

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    Regenexx Team says

    BL,
    This is a question for one of our Physicians. I have inquired and will get back to you.

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    Regenexx Team says

    BL,
    I did ask one of our physicians, and their reply was: "NO experience with this unit, buy it likely doesn't impact motor nerves."

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    Helen says

    I'm supposed to have this procedure done on April 5th . I'm not to sure now. I don't want to lose any mobility . The pain really affects me when I get up and walk from sitting, and when I'm laying down, I can only lay on my back , If I lay on my side. it feels like a knife is going in my low back . What do you think ? Ive always heard your nerves alert you to a bigger problem.

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    Regenexx Team says

    Helen,
    It's not something we recommend, as killing off nerves has consequences. The problem can be treated instead with your own stem cells or platelets to repair and heal. Please see: http://www.regenexx.com/the-regenexx-procedures/back-surgery-alternative/ Here is a list of Regenexx Providers: http://www.regenexx.com/find-a-physician/

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    Tracie Byers says

    I messed up my left foot and ankle in a fall. The surgeon was supposed to go in and connect the small and large tendons in my foot to give my ankle more support. During surgery he saw that my small tendon was very damaged. He cut it out! My pain/problems increased. Today another doctor did an ultrasound and emg. He discovered that 2 nerves were damaged. 1 from the fall, the other from the surgery. He said only 20-30% of the nerve is working. He recommended killing that nerve. Needless to say, I'm very apprehensive.

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    Regenexx Team says

    Tracie,
    Thankfully you're apprehensive regarding such an irrereversible plan, as there are other options. In a case like this, it's definitely worth trying to perform platelet lysate hydrodissection before killing the nerve. Please see: https://www.regenexx.com/radial-nerve-treatment/ If you'd like to see if you'd be a candidate for this type of procedure, please submit the Candidate form.

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    Stacy says

    I had a couple of Rhizotomies done about 5 years ago I also have MS and had Brain surgery in 1997. My entire right side has been somewhat numb ever since my brain surgery, however in the last few months the right side of my back has become majorly numb. So much so that I feel nothing. Could this be from the Rhizotomies years ago or do you think it's the MS?

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    Regenexx Team says

    Stacy,
    These are questions for your neurosurgeon and the Physician treating your MS. That said, cutting nerve roots in Rhizotomy, like burning nerves to destroy them in Radio frequency Ablation, means the nerves no longer function.

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    Theresa Mass says

    I've had at least 8 rhitzos on both sides of my lower spine each and one on both sides of neck due to OA since 2012. I've had numerous unimaginable falls this year. Can it be related to procedures? Any way to improve situation?

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    Regenexx Team says

    Theresa,
    Killing nerves which stabilize the spine isn't a good idea. We'd need to examine you to see if the falls are likely related, or whether they are a symptom of something else. Let us know if you'd like to do that. Please see: https://www.regenexx.com/never-proud-mris-show-holes-burned-patients-bodies/

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    Melissa says

    I had this procedure done 8 days ago. I'm in so much pain down my leg. It hurts to touch from my knee down and it's a weird numb, tingling feeling. And it feels like it's on fire. I feel like I have pinched nerves in my spine and muscle spasms. All of this on top of my pain I originally was getting treated. Is this normal? It's pure agony!

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    Regenexx Team says

    Melissa,
    Killing nerves and tissue is a bad idea. Please contact the Dr. that did the procedure as some of those issues warrant looking into.

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    Melissa says

    Its going on 7 months now and I still suffer in a lot of excruciating pain. The doctor has been trying different medications (gabapentin and lyrica) and nothing has helped as of yet. In the last 2 months, my right arm is tingling and numb...right to my fingertips. I’ve seen a neurologist and he suspects that I have sensory nerve damage. Has anyone heard of this side effect happening before, if so, how long did it last and what worked to relieve the pain? I’m feeling like there’s no hope at the end of my pain tunnel.

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    Regenexx Team says

    Melissa,
    What area was treated with RFA?

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    About the Author

    Chris Centeno

    Christopher J. Centeno, M.D. is an international expert and specialist in regenerative medicine and the clinical use of mesenchymal stem cells in orthopedics. He is board certified in physical medicine as well as rehabilitation and in pain management through The American Board of Physical Medicine and Rehabilitation.…

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