Endoscopic Facet Rhizotomy (Lumbar)

Indications: chronic low back pain, failed back surgery syndrome, facet joint arthritis, facet joint injuries, facet hypertrophy, whiplash syndromes.

  • Patient typically has low back pain for more than 6 weeks and the pain does not respond to conservative treatment.
  • Palpation of facet joints demonstrated deep tenderness and muscle spasm.
  • Patient usually has limited range motion of lumbar spine, particularly on extension (bending backwards)
  • Facet joint blocks or medial branch nerve blocks confirm low back pain is from facet joint diseases.

Procedures: The patient is under local anesthesia and intravenous sedation. The surgical targets are marked at the skin level under fluoroscopic guidance (X-rays). A small cut (7 mm) is made at the skin and a tube is inserted to the target. The endoscope is placed and the small nerve branches (medial branch) from the nerve root are identified under direct vision. These nerves only have sensory function. Laser light is used to deaden the nerve branches.