Endoscopic Rhizotomy Procedure in Arizona

Endoscopic Rhizotomy Procedure in Arizona

An endoscopic rhizotomy offered by DISC surgeons in Phoenix, AZ, is the least invasive yet most effective treatment option for chronic low back pain. 

The outpatient procedure, performed through an ¼ inch incision, is the smallest in spine surgery. The endoscopic procedure targets the medial branch nerves located around the facet joints that relay the pain signal in your low back muscles to your brain.

When our surgeons directly visualize these nerves with an HD endoscope, they can ablate the nerve using a laser or radiofrequency probe with confidence, thus providing patients with long-term pain relief.  

Invented & Developed at DISC

The endoscopic rhizotomy procedure was invented and developed at DISC by Anthony Yeung, MD (retired). Dr. Yeung saw a need to improve upon a pain management procedure called radiofrequency ablation (RFA), performed without direct visualization under X-ray guidance.

An RFA only provides patients temporary pain relief for six to twelve months. Endoscopic rhizotomy surgery significantly improves low back pain relief lasting up to five years. For many patients, this procedure is an excellent alternative to a lumbar spinal fusion. If you want to talk to one of our professionals about if an Endoscopic Rhizotomy procedure is for you, contact us or make an appointment today!

Contact Us


What Symptoms Does an Endoscopic Rhizotomy Treat?

The endoscopic rhizotomy is a highly targeted procedure for patients suffering from low back symptoms related to the facet joints.

  • Low back pain
  • Low back muscle spasms
  • Pain when leaning backward
  • Spinal joint pain

What Conditions Can be Treated with an Endoscopic Rhizotomy?

Proper patient selection is crucial to the success rate of an endoscopic rhizotomy. At DISC, all patients undergo a personalized pain mapping process that selectively pinpoints the low back pain generator. Suppose patients get significant (greater than 50%) pain relief from a medial branch injection or facet joint injection. In that case, they typically respond very well to an endoscopic rhizotomy. Endoscopic rhizotomy patients report a 90% success rate with up to 5 years of pain relief.


How is an Endoscopic Rhizotomy Performed?

An endoscopic rhizotomy is genuinely the least invasive outpatient surgery. Before the procedure, our anesthesiologist or trained nurse will place an intravenous (IV) catheter on your wrist and then take you to the operating room. 

Once positioned on the table and comfortable, the anesthesiologist will administer conscious sedative medicine through your IV. Under X-ray, our surgeon will precisely target and mark your painful facet joints or transverse process. Then he injects a local anesthetic at the skin surgical site for your maximum comfort. 

The surgeon utilizes a radiofrequency probe or straight firing laser to ablate and sever the medial branch nerve. Severing this small nerve disconnects the pain signal from your back to your brain. Afterward, the cannula is removed from your back, and the incision is closed with a Steris strip band-aid. 
The process is repeated for each painful nerve level on one or both sides of your back. The rhizotomy procedure only takes about 30-45 minutes on average.

Endoscopically-guided Rhizotomy for Axial Back Pain

Our surgeon then precisely guides a spine needle and guidewire under fluoroscopic X-ray guidance to the transverse process where the medial branch nerve. Next, a small metal dilator and 7mm cannula are inserted through a ¼ inch “keyhole” incision. Finally, an endoscope attached to an HD camera is inserted into the cannula to visualize the medial branch nerves directly.  

Endoscopic Rhizotomy vs. Radiofrequency Ablation (RFA)

There are many differences between an ablation and a rhizotomy. The endoscopic rhizotomy technique is vastly more effective at providing long-term back pain relief than a pulsed or continuous radiofrequency ablation. Both procedures target the pain generator – medial branch nerve of the dorsal ramus, located around the facet joints in your back.

The RFA procedure is done percutaneously under C-arm fluoroscopic X-ray and not directly visualized with the physician’s eye. On the other hand, the endoscopic rhizotomy is directly visualized by the surgeon with an endoscope and HD camera.

The dorsal ramus’s anatomy that innervates the facet joint varies and can contribute to pain management’s failed or short-term results from the RFA procedure. The nerves can also entirely bypass the transverse process, and go directly into the adjacent facet joint.

The RFA procedure merely puts a lesion on the nerves through radiofrequency energy. The nerves regenerate, and the pain returns within 6 – 12 months.  


The endoscopic rhizotomy is the most effective method to ablate the branches of the dorsal ramus. The endoscopic procedure allows the surgeon to identify the painful nerves, directly visualize and then ablate the nerves resulting in long-term relief up to 5 years. DISC’s innovative surgery is also less invasive and less surgically morbid procedure than a spinal fusion. The recovery for endoscopic rhizotomy is two weeks versus three months for a spinal fusion.

What are the Expected Recovery and Success Rates of an Endoscopic Rhizotomy?

After an endoscopic rhizotomy, some patients may experience mild swelling, discomfort, and soreness around the skin incisions. These symptoms may linger for a few days up to a couple of weeks. Patients typically use over-the-counter pain relievers and an ice pack to provide relief.


  • Most patients can return to work and normal activities the next day. However, they should avoid strenuous exercise and heavy lifting until advised by the surgeon. Taking a shower, soaking in the bathtub, or swimming should be avoided until at least 24 hours after surgery.
  • In our experience and our published research, patients who have an endoscopic rhizotomy can expect low back pain to be significantly improved post-operatively and continue to improve to maximum pain relief in about two weeks. This pain relief, as reported in clinical research, can last up to 5 years.

Success Rate

  • The success rate of endoscopic rhizotomy can vary depending on various factors, including the underlying cause of the pain, patient selection, and the skill of the surgeon performing the procedure. Generally, endoscopic rhizotomy has shown promising results in reducing or eliminating low back pain in selected patients who have not responded to conservative treatments.
  • Clinical studies have a reported success rate of 90% pain relief for a term up to 5 years following endoscopic rhizotomy.

When is an Endoscopic Rhizotomy Recommended?

Patients suffering from chronic low back pain related to the facet joints for more than six weeks should seek a second opinion before major spinal surgery.

Suppose you failed to get long-term relief from a pain management radiofrequency ablation (RFA) procedure. In that case, you might be a candidate for an endoscopic rhizotomy.

Some patients offered spinal fusion surgery for low back pain may benefit instead from an endoscopic rhizotomy as a less invasive alternative.

Am I a Candidate?

You may be a candidate for endoscopic rhizotomy if you:

  • Low back pain for more than six weeks
  • Low back palpation by surgeon contributes to pain or spasm
  • Greater than 50 percent relief from medial branch nerve block or facet joint injection
  • Symptoms and pain return after a radiofrequency ablation

If, after reading the above, you believe endoscopic rhizotomy may help you, feel free to contact us for an appointment. Out-of-state and interested in a second opinion? Please fill out our consult request form and a member of the DISC staff will reach out to you immediately.

Request a Consultation Form

Dr Abrams explaining spine x-ray Dr. Abrams laughing

Ready To Enjoy Life Again?

No matter the painful spine condition, a second opinion consultation with one of our expert spine surgeons can help you find the right customized solution that gets you back to enjoying life.


Our spine health blog features up-to-date spine education and expert spine tips from our spine specialists here at DISC.

6 Exercises to Improve Your Posture
November 13, 2023

6 Exercises to Improve Your Posture

Kinesics is the expression of your body language. It’s the shrug of your shoulders, the quick wink to a friend, the unconscious puzzlement of your eyebrows when you can’t quite place a face. Your body evolves as you take on characteristics that define who you are. Your work and exercise routine will also have an […]

All About C5 and C6 Treatments
November 8, 2023

All About C5 and C6 Treatments

Each vertebra plays a role in supporting the body’s structure and facilitating movement. In this article, we will look at the cervical vertebrae, which comprise the upper portion of the spine. Specifically, the fifth (C5) and sixth (C6) vertebrae, as they hold special significance.  C5, the fifth cervical vertebra, finds its position just below C4 […]

treatment options for annular tears
November 7, 2023

Treatment Options for Annular Tears

An annular tear is a discogenic condition that impacts the spine, causing lower back pain. Natural wear and tear, sports injuries, improper lifting and repetitive motions are the most common causes of annular tears, as the injury results from the fibers that make up the intervertebral disc breaking or separating.  While these tears can occur […]

What Is Foraminal Disc Protrusion?
November 3, 2023

What Is Foraminal Disc Protrusion?

Foraminal disc protrusion, which is one way that contributes to foraminal stenosis, is a spinal condition that occurs when a disc in the spine extends beyond its normal boundaries and presses on the nerve roots within the foraminal canal. This canal is a passageway through which nerve roots exit the spinal cord and travel to […]

Everything You Need To Know About Restless Leg Syndrome
October 18, 2023

Everything You Need To Know About Restless Leg Syndrome

Do you ever have trouble sleeping because your legs and feet feel itchy, tingly or cramped? You may be experiencing restless legs syndrome (RLS), a condition that affects up to 10% of people in the United States. RLS usually happens at night or when a person has to sit still for a long time.  Depending on its […]

tiny cameras are now taking center stage in spinal surgery
September 18, 2023

How Tiny Cameras are Now Taking Center Stage in Spinal Surgery

Dealing with back pain caused by disc degeneration and herniation has long been a challenge. For years, surgeons have been using various techniques to address these issues, with the operating microscope being a crucial tool. However, a game-changing evolution is happening in spinal surgery thanks to a device that’s been around for a while — […]

M6-C Artificial Cervical DISC Two-Level IDE Clinical Study
September 15, 2023

M6™-C Artificial Cervical Disc Two-Level IDE Clinical Study

A Guide to Awake Spine Surgery
September 7, 2023

A Guide to Awake Spine Surgery

Having surgery while awake can sound a little odd, but in the field of spine surgery, it’s been happening for a few decades now. This unique method of surgery offers some exceptional benefits, helping people enjoy less recovery time and supporting surgeons in more accurate, safer procedures. Let’s explore awake spine surgery and how to […]

Myelopathy: Causes, Diagnosis and Treatment
August 19, 2023

Myelopathy: Causes, Diagnosis and Treatment

Spinal injuries can wreak havoc on your life, impacting your organs, motor functions or senses. They must be handled with prompt medical attention to prevent lasting damage. Speak with your doctor if you notice any peculiar symptoms, such as those caused by myelopathy. Myelopathy is a common spinal cord condition that can limit a person’s […]

March 6, 2023

DISC Surgeons Named 2023 Top Docs

Congratulations to DISC’s surgeons, Christopher Yeung, Justin Field, and Nima Salari, for being chosen as Phoenix Magazine’s TOP DOCTOR in 2023.

January 16, 2023

Join Dr. Nima Salari at Amplify Surgical’s 2nd Annual Endoscopic Spine Symposium

Register today for Amplify Surgical’s 2nd Annual Endoscopic Spine Symposium, featuring dualPortal™ and dualX® System on March 4, 2023. 

December 22, 2022

Dr. Chris Yeung Featured on AZ Physicians

Congratulations to Dr. Yeung for being featured on the front cover of Maricopa County Medical Society’s “Arizona Physician” Winter 2022 magazine!

September 2, 2022

Spine Care for Baseball Players Podcast with Dr. Chris Yeung

Dr. Chris Yeung was interviewed by Arizona Physician Magazine – a publication that provides information for physicians across Arizona.

April 11, 2022

DISC Surgeons take Phoenix – Top Doc Award in 2022

Dr. Salari received the most votes in the Orthopedic Surgery of the Spine category. Dr. Yeung received the award for the 10th consecutive year.

January 7, 2022

Dr. Chris Yeung Panelist at UCI Health Webinar

DISC surgeon Dr. Chris Yeung participates as a panelist in UCI Health Comprehensive Spine Center Webinar Series on January 14th, 2022.

November 22, 2021

DISC surgeons participate in M.O.R.E. Spine Learning Center

DISC surgeons Dr. Salari and Dr. Wang participated as instructors in a recent M.O.R.E. Education Spine Program in Phoenix, Arizona on November 19-20, 2021. The M.O.R.E. Spine Learning Center offers surgeons the opportunity to attend cadaver labs, meet experienced surgeons and discuss the clinical, technical and economic aspects of new spine treatment technologies.

September 22, 2021

Join Dr. Chris Yeung at an Endoscopic Workshop at NASS

Begin or advance your Endoscopic skills at NASS on September 29th, 2021. Elliquence is dedicated to ensuring the best education for doctors and physicians on the Endoscopic Spine and MIS procedures using didactic and cadaveric hands-on instruction.

Spine Surgeon Spotlight - Dr. Nima Salari
September 14, 2021

Dr. Nima Salari Listed On Becker’s “50 Spine Surgeons To Know”

We are proud to announce that Dr. Nima Salari has been named to Becker’s Spine Review “50 Spine Surgeons To Know.” Written by Carly Behm | August 26th, 2021 Nima Salari, MD. Desert Institute for Spine Care (Phoenix). Dr. Salari was reportedly the first spine surgeon to implant Amplify Surgical’s 12-degree hyperlordotic DualX interbody cage. His specialties include pathologic conditions of the spine and minimally invasive surgery.