Endoscopic facet thermal ablation is a minimally invasive procedure that destroys damaged sensory nerves within facet joints to reduce spinal pain. This treatment is typically recommended for patients with degenerative facet joints or arthritis of the spine. Healthy facet joints allow the spine to bend, twist, and move comfortably. If the cartilage surrounding the facet joint begins to deteriorate from natural wear and tear, injury, or overuse, nearby sensory nerves become inflamed and irritated. Endoscopic facet thermal ablation uses an x-ray guided laser to deaden sensory nerves, which stops the transmission of pain signals to the brain.
Endoscopic facet thermal ablation is performed under local anesthesia and conscious IV sedation. Patients are kept awake to provide feedback about their pain. During the procedure, a small, percutaneous incision is made above the affected facet joint. Using fluoroscopic guidance, a pin is placed onto the facet joint to ensure location accuracy. A facet is then placed over the pin, and the pin is removed to make way for the laser device. The laser is then inserted through the incision and placed over the facet to begin the ablation process. Damaged sensory nerves are targeted and deadened by the laser throughout the procedure. Patients may be asked to complete a series of mobility exercises to confirm the success of the treatment. Once the procedure is complete, the laser is removed, the incision is closed, and a dressing is applied over the surgical site.
The procedure takes about 40 minutes to an hour to complete, not including pre- and post-operative monitoring. After the procedure, patients are transferred to a room to recover. A friend or family member will need to drive the patient home after the procedure to prevent serious complications or accidents. Our surgeons will develop a walking regimen and provide prescriptions for antibiotics and pain management after the operation. During this time, a follow-up appointment will be made to monitor the patient’s progress and healing. Patients should avoid strenuous activities for several days after endoscopic facet thermal ablation. If muscle soreness is present, a cold compress and rest should relieve some of the discomfort.