July 21, 2015

Endoscopic Assisted Nerve Excision

Our endoscopically-assisted nerve excision procedure targets and removes irritated nerve sections that are often caused by enlarged or worn out spinal joints. Sometimes called a nerve ablation, neurotomy, rhizotomy or avulsion of the median or lateral branch nerves, the procedure done at Spine Institute Northwest accurately targets the area using visualization devices and pain site targeting techniques. The procedure is more tissue-sparing than traditional surgery and offers:

  • Fast Recovery
  • Less postoperative pain
  • Small incision
  • Minimal bleeding
  • Same day, outpatient procedure
  • Most procedures do not require general anesthesia



This minimally invasive surgical technique uses ablation and a visualization device called endoscope or arthroscope to treat nerve pain by removing the problem area. Before the procedure, the origin of the pain is located with an injection technique that uses numbing medication to confirm the site. During the procedure, the endoscope is inserted into the pain generating nerve site. Then, a laser or radiofrequency probe is used to remove the pain generating nerves are removed (avulsed or ablated) under direct visualization and X-ray guidance. This process interrupts the pain impulses running up and down the targeted nerve, stopping the pain impulses felt in the area.


This type of surgery allows most patients to be in and out of our surgical center in one day, with a typical surgery time of about 30 minutes per nerve. This procedure uses local anesthesia and intravenous sedation medication(s). Immediately after surgery, expect to feel a bit of discomfort or local swelling in the surgical area. Ice and anti-inflammatory medications (such as Advil or Aleve) should help. These symptoms might persist for 4-6 weeks, and scarring often completely disappears after 2-4 months. You may return to work within days, but please discuss this with your surgeon first.

As this procedure uses newer and advanced technologies, there are few published clinical outcomes; as such, we encourage our patients to register with the UW Pain Medicine established clinical outcomes database, C-PAIN. The existing clinical outcomes so far are very promising for long term benefits.


Though our facility has a 0% infection rate and uses techniques that result in far less risks than traditional open-back surgery, all surgeries come with risks. Risks include swelling of the area, bruising, and incision pain after procedure, and/or loss of sensation to the wrong nerve. Careful steps are taken in all of these areas to minimize risks and maximize efficacy of treatment.