Rhizotomy in Staten Island

Rhizotomy at our Staten Island, NY location uses precisely delivered radiofrequency energy to disrupt the nerve signals responsible for chronic facet joint pain, offering Staten Island patients relief that outlasts conventional injections by months or years.

Confirmed Source, Temporary Relief: Rhizotomy Goes Further

For patients with chronic neck or back pain originating from the facet joints, diagnostic injections can confirm the source and provide temporary relief. Rhizotomy takes the next definitive step, using controlled radiofrequency energy to disrupt the medial branch nerves responsible for transmitting that pain on a more lasting basis.

At Gerling Spine Care and Research Institute, rhizotomy is performed as part of a structured, diagnostically rigorous clinical pathway, applied only after the evidence base for the procedure has been carefully established for each Staten Island patient, now available close to home. Contact our Staten Island office today to find out whether Rhizotomy is the right next step for you.

What Is Rhizotomy?

Rhizotomy, also known as radiofrequency ablation (RFA), uses radiofrequency energy to heat and disrupt the medial branch nerves responsible for transmitting pain signals from the facet joints to the brain. Once disrupted, the nerve can no longer carry the pain signal, providing relief that typically lasts between nine months and two years.

How Rhizotomy Differs From Injections

Facet joint injections and medial branch blocks deliver medication to reduce inflammation or temporarily interrupt the pain signal. Their effect is limited by the duration of the medication. Rhizotomy physically disrupts the nerve itself, producing relief that does not depend on medication and does not wear off in the same way.

For patients who have had positive responses to medial branch blocks but found the relief too short-lived, rhizotomy is the logical and clinically appropriate next step.

The Diagnostic Foundation

Rhizotomy is not performed without first confirming through medial branch block injections that the facet joints are the primary pain source. Most clinical protocols require two separate positive block responses before rhizotomy is recommended, ensuring the procedure is reserved for patients with the highest likelihood of meaningful and lasting benefit.

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Dr. Gerling performing a neurological reflex test on a patient

How Rhizotomy Works

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

Once the position is confirmed, local anesthetic is administered, and radiofrequency energy is delivered through the needle tip, generating controlled heat that disrupts the nerve's ability to transmit pain. The procedure typically takes less than one hour, and most patients are home the same day.

Conditions Treated With Rhizotomy

Rhizotomy is most appropriate for chronic spinal pain confirmed through prior diagnostic injections as originating from the facet joints. It is used for patients with:

Facet joint arthropathy or osteoarthritis of the cervical, thoracic, or lumbar spine
Facet joint syndrome producing chronic axial neck or back pain
Degenerative spondylosis with significant facet joint involvement
Chronic spinal pain following whiplash or injury with confirmed facet contribution
Sacroiliac joint pain in select cases where the medial branch nerves are involved

It is not appropriate for pain primarily caused by disc herniation, nerve root compression, or other non-facet pathology.

Are You a Candidate for Rhizotomy in Staten Island?

The clearest indicator of candidacy is a significant and reproducible reduction in pain following two separate medial branch block injections. Beyond that, good candidates have chronic axial spinal pain lasting three months or longer, have not achieved lasting relief from conservative care or therapeutic injections, and are in acceptable overall health for an outpatient procedure.

Our Staten Island team will review your full clinical and injection history before making any recommendation, and will not proceed to rhizotomy without the diagnostic foundation that gives the procedure its best chance of producing meaningful and lasting relief.

What to Expect From Rhizotomy in Staten Island

Rhizotomy is one of the most efficient procedures in our practice, with a straightforward recovery and a fast return to normal activity for most patients.

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 and the radiofrequency mechanism clearly, and walk through realistic expectations for duration of relief and the possibility of repeat treatment before any decision is made.

The Day of Your Surgery

The procedure is performed under local anesthesia with mild sedation. You will need a driver to bring you home afterward. Most patients experience mild pressure during the procedure but report minimal pain. Some temporary soreness or bruising at the treatment site is normal in the days that follow and resolves without intervention.

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 typically begins within days and reaches its maximum benefit within two to four weeks. Relief generally lasts between nine months and two years. Because the medial branch nerves can regenerate over time, the procedure can be repeated if and when pain returns.

Why Choose Gerling Spine Care and Research Institute?

The effectiveness of rhizotomy is directly tied to the quality of the diagnostic work that precedes it. Our Staten Island team follows established clinical protocols precisely and approaches every chronic pain case with the systematic rigor of a research institution, ensuring rhizotomy is applied only where the evidence clearly supports it.

For Staten Island patients who have been searching for a more definitive answer to their chronic spinal pain, that standard of diagnostic and clinical care is now available close to home.

Rhizotomy Frequently Asked Questions

How long does pain relief from rhizotomy last?

Relief typically lasts between nine months and two years, depending on the individual and the degree of nerve disruption achieved. Because the medial branch nerves can regenerate over time, the procedure can be repeated when pain returns, often with similar results.

Is rhizotomy the same as radiofrequency ablation?

Yes. Rhizotomy and radiofrequency ablation are often used interchangeably in the context of facet joint pain treatment. Rhizotomy is a broader term referring to nerve disruption procedures, while radiofrequency ablation specifically uses heat energy to interrupt pain signals from the medial branch nerves.

Will I feel pain during rhizotomy?

The treatment area is numbed with local anesthetic before the procedure begins. Most patients experience only mild pressure or a brief warm sensation. Mild IV sedation may also be offered for additional comfort during the procedure.

What happens if rhizotomy does not relieve my pain?

If rhizotomy does not provide expected relief, it may suggest that pain is originating from structures other than the facet joints. In that case, further evaluation is performed to reassess the diagnosis and guide alternative treatment options. In select cases, endoscopic rhizotomy may be considered if conventional radiofrequency ablation was ineffective.

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

Yes. If diagnostic testing confirms facet-mediated pain at multiple levels, rhizotomy can be performed at more than one level during the same session. This is commonly done when clinically appropriate and confirmed through prior diagnostic medial branch blocks.