Rhizotomy in Queens

Rhizotomy at our Queens, NY location is a minimally invasive procedure that interrupts pain signals from spinal nerve roots, providing lasting relief for chronic neck and back pain.

When Pain Keeps Coming Back, It's Time to Address the Signal at Its Source

For patients with chronic neck or back pain caused by irritated spinal nerve roots or arthritic facet joints, injections and conservative care can provide relief — but often not for long. Rhizotomy takes a more definitive step by disabling the specific nerves responsible for transmitting the pain signal, offering relief that can last a year or more. At Gerling Spine Care and Research Institute, rhizotomy is an important part of our comprehensive, conservative approach to spine care for Queens patients.

Contact our Queens office today to find out whether Rhizotomy is the right next step for you.

What Is Rhizotomy?

Rhizotomy, also known as radiofrequency ablation (RFA), is a minimally invasive procedure that uses radiofrequency energy to heat and disrupt the nerve fibers responsible for transmitting pain signals from the spinal facet joints or other pain-generating structures to the brain. Once the nerve is disrupted, it can no longer carry the pain signal, providing meaningful and often long-lasting relief.

The word rhizotomy comes from the Greek roots for "root" and "dividing," reflecting the procedure's core function: disabling the root of the pain signal rather than simply masking it.

How Rhizotomy Relates to Medial Branch Blocks

Rhizotomy is typically performed as the next step after a positive response to diagnostic medial branch block injections. The blocks confirm that the facet joints are the primary pain source; the rhizotomy then addresses those same nerves on a more lasting basis. This step-by-step diagnostic and treatment pathway ensures that rhizotomy is performed on patients most likely to benefit from it.

How Rhizotomy Works

Rhizotomy is an outpatient procedure performed under local anesthesia, typically with mild sedation for comfort. The patient lies face down while the treatment area is cleaned and numbed. Using fluoroscopic guidance, the physician precisely positions a specialized needle alongside the targeted medial branch nerves. A small electrical current is first passed through the needle to confirm correct placement, which may cause a brief muscle twitch or mild sensation.

Once the position is confirmed, additional local anesthetic is administered, and radiofrequency energy is delivered through the needle, generating controlled heat that disrupts the nerve's ability to transmit pain signals.

The procedure typically takes less than one hour, and most patients are discharged home the same day.

Dr. Gerling performing a neurological reflex test on a patient

Conditions Treated With Rhizotomy

Rhizotomy is most commonly used to treat chronic spinal pain originating from the facet joints, confirmed through prior diagnostic injections. Appropriate conditions include:

Facet joint arthropathy or osteoarthritis of the cervical, thoracic, or lumbar spine
Facet joint syndrome causing chronic axial neck or back pain
Degenerative spondylosis with facet involvement
Sacroiliac joint pain in select cases
Chronic spinal pain following injury or whiplash that has not responded to conservative care

It is not appropriate for pain primarily caused by disc herniation or nerve root compression, and candidacy depends on a clear positive response to prior diagnostic injections.

Are You a Candidate for Rhizotomy in Queens?

The most reliable candidates for rhizotomy are patients who have already undergone diagnostic medial branch block injections and experienced significant, reproducible pain relief from them.

Most protocols require two separate positive blocks before rhizotomy is recommended, to confirm the diagnosis with sufficient certainty.

Beyond a positive diagnostic response, good candidates generally have chronic axial neck or back pain lasting three months or longer, have not achieved lasting relief from conservative care, and are in acceptable overall health for an outpatient procedure. Our Queens team will review your full clinical history and prior injection responses before making any recommendation, ensuring the procedure is matched to the right patient.

We’re here to help you move forward.

What to Expect From Your Rhizotomy in Queens

Rhizotomy is one of the most straightforward procedures in our practice, with minimal downtime and a fast return to normal activity.

Before Your Rhizotomy

Your consultation will include a review of your diagnostic injection history, imaging, and symptom pattern. Our team will confirm your candidacy, explain the procedure in detail, and walk through realistic expectations for relief duration and possible recurrence before any decision is made.

The Day of Your Surgery

The procedure is performed under local anesthesia with mild sedation and typically takes under one hour. You will need a driver to bring you home afterward. Most patients feel mild pressure during the procedure but report little to no significant pain. Some temporary soreness or bruising at the treatment site is normal in the days following.

Recovering After Your Procedure

Most patients return to normal activities within 24 to 48 hours. Some initial soreness at the procedure site is expected as the treated area heals. Pain relief may begin within days and typically reaches its maximum benefit within two to four weeks.

Relief from rhizotomy generally lasts between nine months and two years. Because the nerve fibers can regenerate over time, the procedure can be repeated if pain returns.

Why Choose Gerling Spine Care and Research Institute?

Gerling Spine Care and Research Institute approaches every case of chronic spinal pain with the same commitment to precision and evidence-based care, whether the solution is a minimally invasive procedure like rhizotomy or a more complex surgical intervention. Our lead surgeon has over 40 peer-reviewed publications, and the institute has more than 300 in total, with active leadership in NASS, CSRS, and LSRS.

Our Queens patients benefit from a team that takes a systematic, diagnostic approach to pain management and recommends rhizotomy only for patients who are genuinely likely to benefit.

Rhizotomy Frequently Asked Questions

How long does pain relief from rhizotomy last?

Relief typically lasts between 9 months and 2 years, depending on the individual and the extent of nerve disruption. Because the medial branch nerves can regenerate over time, the procedure can be repeated if and when pain returns.

Is rhizotomy the same as radiofrequency ablation?

Yes. Rhizotomy and radiofrequency ablation (RFA) are two names for the same procedure. The term rhizotomy broadly refers to procedures that disrupt nerve roots, while radiofrequency ablation specifically refers to the use of heat energy to achieve that disruption. In the context of spine pain management, the terms are used interchangeably.

Will I feel pain during rhizotomy?

The treatment area is numbed with a local anesthetic before the radiofrequency energy is delivered. Most patients feel mild pressure or a brief warm sensation during the procedure rather than significant pain. Mild sedation is typically available for patients who prefer added comfort.

What happens if rhizotomy does not relieve my pain?

If rhizotomy does not provide the expected relief, it may indicate that additional pain generators beyond the facet joints are contributing to your symptoms. Our team will reassess your clinical picture and explore alternative diagnoses and treatment options. In some cases, endoscopic rhizotomy may be considered for patients who do not respond adequately to radiofrequency ablation.

Can rhizotomy be performed at multiple spinal levels in one session?

Yes. When pain originates from facet joints at multiple levels, the procedure can be performed at several levels during a single session, which is both convenient for the patient and efficient for diagnostic and therapeutic purposes.