Lateral sacral branch rhizolysis (neurotomy) ...
The sacroiliac joints form the connection between your pelvic bones and your backbone. Irritation of these joints can lead to nerve pain in that area, and often buttock and posterior thigh pain. Your doctor thinks rhizolysis (electrocautery or thermal lesioning) of these nerves may give you long term pain relief.
The treatment pathway to rhizolysis involves first undergoing diagnostic injections (lateral sacral branch blocks), with the result that you gained temporary pain relief, confirming that your back pain is caused by irritation of your sacroiliac joints.
What is the procedure?
A rhizolysis is a therapeutic procedure that involves heating the nerve up with a special needle. We normally expect patients to experience pain relief for 6-12 months after this procedure, but this depends on how long it takes for the outer layer of the nerve to regrow and is variable between individuals.
What does the procedure involve?
The procedure is performed as a day procedure in an operating theatre. When you arrive, the nursing staff will prepare you for theatre. In theatre, you will be asked to lie face down on the operating table, The area around the injection site will be cleaned with antiseptic and drapes will be placed around the operative area. You will be given a sedative anaesthetic for this procedure. The needles used to inject the local anaesthetic will be inserted under x-ray guidance and the injections and electrocautery performed once they are in the correct place.
If you are, or think you may be pregnant, please contact our office as soon as possible, as x-rays are contraindicated in this circumstance.
What happens after the procedure?
After the procedure is performed, you will be monitored for a short time and given something to eat and drink before you go home, Dr Cornish will review you prior to discharge, which isusually discharged between 1-3 hours after the procedure. You must organise for someone to drive you home after the procedure as you will not be allowed to drive after your sedative anaesthetic.
Approximately 2-4 weeks after your procedure you will have a follow up appointment with Dr Cornish to assess the outcome of the procedure, and a plan for your ongoing assessment and care will be formulated. You should attend this appointment at Specialised Pain Medicine in Unley.
What are the possible complications?
These procedures have a very low risk of complication, but there are some that you should be aware of.
Local discomfort: some patients may experience some discomfort in the area of the injection for a few hours or a few days. This is the most common complication for these procedures.
Increase in pain: some patients may also experience a temporary increase in their pain symptoms (usually a few days to a couple of weeks). If this happens, you should take simple pain medication (e.g. Panadol) for the first few days. You may also find that heat or cold packs help.
Bleeding or infection: these are very rare. Please contact our office immediately if you develop fever or back pain after the procedure. If these symptoms occur outside normal office hours, please go to the nearest emergency department.