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Facet Syndrome

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Surgery for Facet Syndrome

The goal of surgery for facet syndrome is to relieve pain, stabilize the spine, and increase a person’s ability to move. Only in extremely rare situations is immediate surgery required for facet syndrome. The neurosurgeons of the Weill Cornell Medicine Center for Comprehensive Spine Care may recommend surgery if:

  • Conservative treatments prove ineffective.
  • It is difficult to stand or walk.
  • The pain is so severe that it is debilitating.


Because the symptoms of facet syndrome often mimic other medical conditions, it is important to be seen by a highly trained team of specialists to be properly diagnosed and treated. At the Weill Cornell Medicine Center for Comprehensive Spine Care, our specialists have advanced training in diagnosing and treating conditions of the spine. They believe in an interdisciplinary approach to treating back pain, including physiatry, pain management, physical therapy, and – only when necessary – minimally invasive surgery.

Minimally Invasive Surgery for Facet Syndrome

Joint injections: A numbing solution and a corticosteroid injected into the facet joint can reduce inflammation. The relief may be temporary but can be repeated up to three or four times a year. A neurosurgeon will use live X-ray guidance to ensure the proper placement of the medicine into the facet joint.

Nerve ablations/blocks: Radiofrequency ablation uses image guidance to deliver an electric current to destroy the nerve fibers carrying the pain signals from the facet joint to the brain. It can often be performed without general anesthesia.

If conservative treatments, joint injections, and nerve ablations do not alleviate the pain of facet syndrome, the neurosurgeons may recommend minimally invasive spinal surgery. Our spine surgeons have developed expertise in some of the most advanced minimally invasive surgical techniques, which require only tiny incisions and often take less than an hour. This type of surgery causes less trauma than older surgical methods and requires much less time in the hospital.

Minimally invasive lumbar fusion: This surgery fuses the bones of the spine in the lower back together so that there is no longer any motion between them. This reduces spinal pressure, pain, and nerve damage. In most patients undergoing lumbar spinal fusion, metal titanium instrumentation is also used. This procedure is commonly used to treat spondylolisthesis and spinal compression fractures. The neurosurgeons at Weill Cornell Medicine are experts in an advanced procedure called transforaminal lumbar interbody fusion (TLIF), in which the surgeon fuses the affected vertebrae from behind. Bone grafts, spacers, and rods and screws stabilize the fused vertebrae. Learn more about TLIF.

Surgery for severe facet syndrome pain is best performed at a major spine center with doctors trained and experienced in the most up-to-date minimally invasive techniques. Learn more about surgeons who treat facet syndrome.

Although minimally invasive procedures may help the symptoms of facet syndrome, it is important to recognize that they do not change the underlying arthritic conditions. For continued best results, an individual needs to maintain a healthy lifestyle, including avoiding smoking, eating a balanced diet, and keeping up with regular stretching and strengthening exercises prescribed by the medical team. These exercises, along with cardiovascular activities, may reduce stress, lower inflammation, and improve overall health.

Reviewed by: Kai-Ming Fu, MD, PhD

Last reviewed/last updated: March 2018