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What Causes Facet Degeneration?

The vertebral column is made up of a long row of small bones stacked one on top of another and divided by cushioning intervertebral discs. Each bone is connected to the next by a pair of small joints called facets. Over time, these joints can wear away, causing the development of painful arthritis. While many people suffer from facet degeneration, there are medical and surgical options available to relieve pain and improve mobility.

Over time, the activities of daily life can cause wear and tear on the facets in the neck and back. These tiny joints are lined with cartilage, and that cartilage can gradually be worn away, causing irritation of nerves and changes in the shape of the bone that limit mobility. The nerves in the area can be damaged, leading to chronic pain. In addition, obesity, improper lifting techniques, and old injuries can all contribute to the degeneration of the facets. People experiencing facet degeneration may have pain, numbness, and limited mobility in the area of the spine where the facet is degenerating.

How is Facet Degeneration Treated?

Once facet degeneration has been diagnosed, the first step is to pursue medical treatment. This is effective in a large percentage of patients. The physician injects the facet with a combination of a local anesthetic and a corticosteroid. This relieves inflammation in the nerves that supply sensation to the affected joint and in the joint tissues themselves. For some people, medical treatment brings pain from facet degeneration under control. However, because it does not solve the underlying cause of the facet degeneration the pain returns in time.

If medical treatment has been effective but is not good for controlling long-term pain, facet ablation is a surgical option for permanently controlling degenerative facet pain. With the patient anesthetized, a small tube is inserted into the area of the nerve that supplies the degenerating facet. Using laser surgery and endoscopic instruments, the nerve is deadened and excess tissue that is causing pain is removed from the joint. When laser surgery is used to remove the tissue and destroy the nerve, the procedure is called facet thermal ablation. The end result is a joint that is able to move more normally and absence of the damaged nerve that was causing chronic pain.

What to Expect after Facet Ablation

This procedure is very brief, and patients generally are able to go home the same day. Walking is encouraged, and patients are able to resume normal activities usually within two weeks. Thermal ablation is a minimally invasive way to relieve the pain of facet degeneration.


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