Endoscopic Laser Facet Rhizotomy


The facet joints are located on each level of the posterior aspect of the spine, with one located on each side. They can be found in the cervical, thoracic, and lumbar spine. The facet joints are synovial joints which have articular cartilage that covers the ends of the bones. Articular cartilage has a smooth, shiny surface allowing the ends of the bones to slide freely over one another. Facet joints are surrounded by a protective sleeve of soft tissue called a capsule, which is lubricated by synovial fluid. Each joint can be a source of pain if irritated or inflamed. Each facet joint has two medial nerves that carry signals (including the signal for pain) to the body. If these nerves are damaged or degenerating they can produce irritation and chronic pain.

Facet nerve blocks, or medial branch blocks, may be used to confirm the source of pain as coming from the nerve. Patients who have not responded to other conservative interventions such as facet injections, medication and physical therapy may be candidates for Endoscopic Laser Facet Rhizotomy.

Laser facet rhizotomy is a minimally invasive spinal surgery usually done as an outpatient procedure while the patient is under local anesthesia. During the procedure, the surgeon will make a small incision to insert an endoscope (a small flexible tube with a video camera) into the targeted location, so as to see the nerve branches. The surgeon then uses a laser to deaden these nerve branches thereby eliminating the patient’s pain.

The patient may feel immediate relief, and recovery time is short due to this minimally invasive approach.

Indications


  • Facet Disease
  • Facet Hypertrophy
  • Spinal Degenerative Joint Disease
  • Spondylosis
  • Months of conservative care with no relief