What Is a Percutaneous Rhizotomy?

A percutaneous rhizotomy is a minimally invasive procedure to treat trigeminal neuralgia. Our surgeons use a small needle to make a controlled, minor injury to one of your facial nerves (your trigeminal nerve). This controlled injury disrupts the pain signals that your trigeminal nerve sends out.

Why Choose University of Utah Health?

U of U Health specialists offer comprehensive treatment for all types of facial pain. Our multispecialty team includes neurosurgeons, interventional pain specialists, and neurologists specializing in nonsurgical treatments. Many of our specialists see a high volume of patients with facial nerve pain, increasing our experience and expertise.

We offer a wide range of treatments for trigeminal neuralgia and other types of craniofacial pain, providing coordinated treatment from a team of experts. Our providers are members of national organizations, including the Facial Pain Association, which allows you access to peer support groups and extra resources.

Candidate Criteria for Percutaneous Rhizotomy

Our specialists offer surgical treatment when medications don’t effectively control your nerve pain. Candidates for a percutaneous rhizotomy include people who:

  • have classical trigeminal neuralgia along with other medical conditions that could increase their risk of experiencing a complication from more invasive treatments, or
  • have secondary or idiopathic trigeminal neuralgia (nerve pain that develops because of another condition or no known reason).

What to Expect during Percutaneous Rhizotomy

You will receive local or general anesthesia so that you don’t feel any discomfort during a percutaneous rhizotomy. A percutaneous rhizotomy takes 30 to 60 minutes to perform. Your neurosurgeon will insert a needle through your cheek to a small opening at the base of your skull where the trigeminal nerve sits.

Then, your neurosurgeon will use one of the three following techniques to damage the nerve and interrupt pain signals:

  • balloon rhizotomy (inflating a balloon to injure the nerve),
  • glycerol rhizotomy (adding a type of alcohol called glycerol to the nerve to damage it), or
  • radiofrequency rhizotomy (using targeted heat to damage the nerve).

Your neurosurgeon will consider several factors including the location of the pain (whether nerve pain affects your jaw, cheek, or eye) when recommending a technique.

After a Percutaneous Rhizotomy

You will return home the same day as a percutaneous rhizotomy. You’ll still feel groggy from anesthesia immediately after the procedure, so you’ll need to arrange for someone to drive you home.

Percutaneous Rhizotomy Side Effects & Risks

Side effects of percutaneous rhizotomy include:

  • facial numbness and
  • temporary weakness in your chewing muscles.

These side effects are usually mild. Numbness or weakness may last for a few weeks but typically goes away with time.

Procedure Risks

A percutaneous rhizotomy is a safe procedure. The most significant risk is that pain may return and, rarely, worsen. This procedure treats nerve pain symptoms but doesn’t necessarily cure trigeminal neuralgia.

Percutaneous Rhizotomy Success Rate

Percutaneous rhizotomy has a one-year success rate of around 65 percent. We may offer a repeat rhizotomy or another treatment option such as stereotactic radiosurgery if the pain returns. 

Schedule an Evaluation with Our Neurosurgeons

If you would like to find out more about trigeminal neuralgia surgery, it’s best to get a referral from your primary care provider or neurologist. Your referring provider will run tests that help our neurosurgeons understand your symptoms and needs when you come in for your appointment. 

If you don’t have a referral, you may request an appointment online, request a virtual consultation via MyChart, or call 801-585-6065.

To refer a patient to our neurosurgery team, fill out our referral form or call 801-585-6087.