In those cases where facet joint injection has temporarily relieved the symptoms and they have been incompletely alleviated by cryogenic rhizotomy, then endoscopic visualisation can be used to identify the nerves and especially the anterior nerves. These can be divided by laser sidefire probes using Holmium ablation.
The joints can be opened and the rough surfaces can be sculptured again using Holmium sidefiring laser probes.
In the future such intervention will be combined with Bionucleoplasty when significant settlement requires correction in the presence of facet joint degeneration and overgrowth which would otherwise dictate the need for an instrumented fusion.
