Dr. McRoberts performs a Facet Joint Nerve Ablation in Real Time With a Real Patient.

I have many patients ask me what it is like to have a facet joint nerve ablation or "rhizotomy" and so I decided to video one.
Herein is a video of a patient enjoying a "FJNA."

The process is fairly simple. In most people the anatomy of the facet joint nerve, also called the "medial branch of the dorsal primary ramus" in the lumbar and cervical spine is in the same position, and so its easy to find the location on X-ray or fluoroscopy.
We identify the nerves which innervate the painful joints and then pass a thin needle down to the nerve. The tip of the needle gets hot as we increase the temperature using very precise radio frequency. It forms a spindle shaped lesion about the size of a grain of rice (half a grain in the cervical spine). That lesion interrupts the pain signal in the nerve so that the pain in the joint is no longer felt by the nerve.
This lasts on average around 400 days, sometimes less, sometimes more, then the nerve re-grows back and we have to do the procedure again if need be. Sometimes the arthritic joint has fused by that time and there is no pain. Sometimes the joint arthritis or synovitis has gotten markedly better. Sometimes the pain is the same and we have to re-do the joint.
Regardless, in successful patients the results can be profound with resolution of back and neck pain.

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Facet Joint Nerve BlockFacent Joint Nerve AblationSpine Arthritis