Endoscopically Assisted Lumbar Medial Branch Rhizotomy

Abstract For patients with multilevel lumbar spondylosis and back pain without leg symptoms, few surgical procedures exist to provide relief of pain. Axial back pain has been attributed in part to pain generated at the facet joints. The lumbar rhizotomy has emerged as an effective method for treatment of axial lumbar back pain in these patients. By performing a limited surgical approach and using an endoscopic method, patients report quick recovery without the pain that typically follows a larger surgical approach. This method provides effective means of ablating the medial branch of the dorsal root, with limited side effects and complications. The history of selective root rhizotomy is discussed, with focus on medial branch neurotomy for treatment of back pain. An endoscopically assisted rhizotomy technique using a minimally invasive approach to the lumbar spine is described. This technique may be expanded for use in other parts of the spine.