Facet Nerve Ablation Surgery

Facet nerve ablation is a procedure used to purposefully damage nerves in your spinal column that provide sensation to spinal joints called facet joints. This intentional tissue destruction, or ablation, helps relieve facet joint-related pain by blocking the nerves’ ability to relay pain signals to your brain.

Background Information

Your facet joints form connection points for the sections of your spinal bones (vertebrae) that sit behind your spinal canal. They serve essential purposes that include helping your spinal column withstand the forces of gravity and allowing you to maintain your normal range of back motion. Several nerves are associated with any given facet joint in your neck or back. Some of these nerves merely pass through the area on their way to other parts of your body. Other nerves, called medial branch nerves, supply sensation to the joints themselves. Unlike some of the other nerves in your body, the tiny medial branch nerves have limited processing abilities, and can only send pain signals to your brain when activated. Conditions that can damage the health of your facet joints and trigger pain signaling in your medial branch nerves include trauma-related injuries and arthritis.

Basics of the Procedure

Facet nerve ablation is typically achieved through the application of focused radio waves, also called radiofrequency waves, to the tissues of the medial branch nerves. During an ablation procedure, your doctor will use X-ray imagery to guide a thin, hollow device called a cannula or introducer needle through your skin to the medial branch nerves associated with your damaged facet joint. After confirming proper placement of the cannula , he will pass a radiofrequency-conducting tip through its interior. Next, he will attach this tip to a machine that generates radio waves, then use the focused energy from these waves to burn the targeted nerves in bursts that last roughly 90 seconds. Typically, your doctor will damage multiple areas on any given nerve in order to ensure its destruction.

Benefits of the Procedure

Roughly 70 percent of people who undergo radiofrequency ablation experience significant reductions in their nerve-related pain symptoms. Depending on your individual circumstances, the procedure can disrupt pain signaling in the targeted nerves for anywhere from 3 months to more than a year and a half. However, most people who benefit from the procedure experience symptom relief that lasts for approximately six to nine months. Eventually, your medial branch nerves will heal and start producing pain signals again if the health of your facet joints has not improved. If necessary, your doctor can repeat facet nerve ablation and provide you with additional periods of symptom relief.

Risks of the Procedure

Facet nerve ablation is typically a fairly safe procedure. However, it can potentially produce complications that include soreness, electrical burns, skin or tissue bruising, unintended nerve damage, blood vessel damage and infection. In addition, some people don’t respond to the effects of radiofrequency ablation, or ultimately find that their pain does not stem from problems with their medial branch nerves. You are usually not a good candidate for the procedure if you have an ongoing infection, have heart disease or uncontrolled high blood sugar, or take anticoagulant medications.