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Facet Rhizotomy

Facet joints are the second and third legs of a three legged stool when it comes to lumbar spine. The three legs of the stool are disc, facet joint and other facet joint. Occasionally, facet joints rather than the disc may be the primary source of back pain. The facet joints provide flexibility to the back, but with movement if the joints are inflammed then pain will occur.

In order to determine if the facet joints are painful, an injection of numbing medicine or Xylocaine and steroids may be given into the joint. If there is significant pain, relief  is then determined by pain mapping to determine the joints that are causing the pain. In a facet rhizotomy, a procedure is performed where the pain originating from the facet joints are blocked and do not allow the pain signal to be sent to the brain. In a facet rhizotomy, a needle with an electrode at the tip is placed alongside the small nerves to the facet joint. The electrode is then heated by radiofrequency to deaden these nerves that transmit the pain signals to the brain.

To learn more about Dr. Cotler or to schedule an appointment, please call us on (713) 523-8884 or visit

Howard B. Cotler, MD, FACS, FAAOS is board certified and recertified in Orthopedic Surgery. He is a fellow of the American Academy of Orthopedic Surgery and the American College of Surgeons.

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