What is being treated?
The facet joints are small joints at the back of the spine. In selected people, they are a source of persistent back pain. Medial branch transection (MBT) uses an endoscope to identify and cut targeted nerve branches carrying pain signals from these joints. It aims to reduce pain; it does not rebuild an arthritic joint.
The diagnosis comes first.
Facet arthritis on a scan does not by itself establish the source of pain. Assessment may include diagnostic medial branch blocks to help determine whether these joints are contributing. Treatment choices depend on that assessment, previous care, health and goals.
How does it differ from radiofrequency ablation?
Radiofrequency ablation uses heat to interrupt nerve signaling. MBT uses an endoscopic surgical approach with direct visualization and transection. The choice deserves a discussion of the expected benefits, surgical risks and alternatives—including continued nonsurgical care.
What should I know about results?
Studies of related endoscopic medial branch denervation techniques report pain and functional improvements in selected patients. Techniques and study populations vary, and those results cannot predict an individual outcome. Permanent relief is not guaranteed.
Possible risks include bleeding, infection, altered sensation, nerve injury and incomplete or recurrent pain. Recovery restrictions and return to activity are individualized.
Sources and further reading
Reviewed October 26, 2026. Arthrex Spine education explains the technique; the clinical studies below concern related denervation methods and do not establish results for every MBT technique.
Arthrex Spine: MBT procedure resources ↗Arthrex: patient explanation of MBT Arthrex scientific update: diagnosis and research references Song et al., 2019: randomized comparison, 40 patients Rapčan et al., 2026: endoscopic denervation versus cryoneurolysis, 80 patients