Facet joints connect vertebrae in the spine and allow for fluid and flexible spinal bending, twisting and other movements. Over time, daily wear and tear on the spine causes degeneration, inflammation, cartilage loss, swelling, bone spurs and other arthritic changes in and around the facet joints. These degenerative changes lead to pain, stiffness, loss of spinal range of motion, and irritation of nearby nerves.  


Facet joint degeneration can be a debilitating condition. Chronic pain and stiffness can significantly impact your ability to work, walk, and perform daily tasks. 


One treatment method your doctor may recommend is facet thermal ablation. Facet thermal ablation is a minimally invasive procedure that targets the nerves within the facet joints. Thermal heat is used to destroy the nerve fibers and prevent them from sending pain signals to the brain. 


Facet thermal ablation can effectively relieve severe back and neck pain. Keep reading to learn more.

When Is Facet Thermal Ablation Recommended?

Facet thermal ablation is recommended when pain caused by facet joint degeneration and arthritis hasn’t responded to non-surgical methods. Before recommending the procedure, your doctor will exhaust all non-surgical treatment options, including medications, physical therapy, and injections. 


If conservative treatments aren’t effective, facet thermal ablation may be a good next step. First, your doctor will perform an MRI review to identify the degenerated facet joints. Then, he or she will administer a diagnostic nerve block to numb the affected nerves. If you experience pain relief from the nerve block, it’s a good indicator that facet thermal ablation will be effective.  

Procedure Overview

Facet thermal ablation is a minimally invasive spine procedure performed on an outpatient basis. On the day of the procedure, you’ll be administered an anesthetic and a sedative. Your surgeon will make a small incision over your spine. He or she will insert an endoscope — a tube with an attached fiber optic camera and light — to view and access the affected facet joints. The endoscope will have a channel through which your surgeon can insert small surgical tools and the laser required for the procedure.


Once your surgeon has access to the spinal column, he or she will remove any loose bone spurs or disc fragments. Then your surgeon will use the laser to apply thermal heat to the pain-causing nerves within the affected joints. Thermal heat deadens the nerves and prevents them from sending pain signals to the brain. 


Once the procedure is complete, your surgeon will close the incision with staples or stitches. You’ll be moved to a recovery room until the sedation and anesthesia wear off. After you’re awake and alert, you’ll be encouraged to get up and walk a little bit. Early movement helps reduce post-op pain, stiffness, and tissue scarring.   


You’ll be able to return home a few hours after surgery. Your doctor will give you specific instructions for wound care and movement restrictions. While you should take it easy for the first few days after surgery, you’ll be able to return to normal activities fairly quickly.


The surgery is safe, low-risk, has a fast recovery period, and causes minimal scarring. 

How Effective Is the Procedure?

In many cases, facet thermal ablation can significantly reduce chronic pain symptoms and improve mobility and flexibility for people living with facet joint arthritis. However, keep in mind that the procedure doesn’t reverse or treat the damage caused by spinal degeneration. You should still maintain proactive lifestyle choices — like exercising regularly, losing excess weight, and quitting smoking — that keep your spine strong and healthy. 

BEST Is a Leader in Minimally Invasive Spine Surgery

At BEST Surgery and Therapies, our board-certified surgeons perform the latest techniques in minimally invasive surgical (MIS) spine surgeries, such as endoscopy and micro-instrument techniques. We perform a wide range of surgeries to provide long-lasting chronic pain relief for back, neck, and leg pain. Outpatient spine procedures are performed in our on-site ambulatory surgery center (ASC).


Don’t let back or neck pain hold you back. Please call us to speak with a dedicated Patient Experience Coordinator and schedule your first appointment in our Cincinnati, OH healthcare facility.


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