Minimally Invasive Facet Disease Surgery
Facet disease surgery is almost always the last resort for people who experience back or neck pain and other symptoms associated with the deterioration of the cartilage that lines the vertebral joints. Most patients find that they are able to manage their symptoms through a combination of conservative, nonsurgical treatment methods, such as pain medication, anti-inflammatory drugs, stretching, exercise, or corticosteroid injections. However, if these treatment methods fail to provide relief, surgery might become an option.
Alternative to Open Back Facet Disease Surgery
In the past, the only way to surgically address advanced facet disease was with spinal fusion, which is designed to completely and permanently immobilize a vertebral joint affected by osteoarthritis. One major drawback of fusion for spinal arthritis is that the condition tends to affect more than one vertebral level, and multi-level fusions are not typically recommended.
Fortunately, modern advances in the use of endoscopic technology have enabled many patients to avoid spinal fusion altogether. One minimally invasive procedure being offered by reputable spine centers is a facet thermal ablation, which employs a laser to deaden, or "ablate," a tiny nerve ending within the joint that has been exposed or irritated by cartilage deterioration. Thermal facet ablation proceeds as follows:
- Local anesthesia and deep IV sedation is administered.
- A small incision is made.
- A round, 5-milimeter Depuy tube is inserted into the incision.
- Muscles are pushed aside, rather than torn or cut.
- Fiber optics, a laser, microsurgical tools, and irrigation instruments are inserted through the tube.
- The laser is used to debride (clean) the joint and deaden the nerve.
- The endoscopic tools are removed and the small incision is stitched close.
- After one or two hours of monitoring, the patient is free to go (with a companion).
Shorter Recuperation, Greater Success Rate
Whereas open back facet disease surgery may require up to a year for complete recovery, a minimally invasive procedure such as facet thermal ablation typically requires no more than a month for recuperation. In addition, there is far less risk of failed back surgery syndrome (FBSS), infection, and other potential side effects often associated with open spine surgery.
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