procedure is to be performed on the left or right side as indicated an oblique view of the facet joint at the appropriate level is visualized the endplates are squared on the image intensification the approach is in a midlateral position the pin which measures approximately 1 16 inch in diameter is placed under image intensification to contact the superior articular process at the appropriate level a one centimeter incision is then made at the pin level where the pin enters the skin the pin is secured into the superior articular process with gentle tapping on the pin with a mallet next a t handled soft tissue dilator measuring 6 25 mm in diameter is advanced over the guide pin to create soft tissue access from the skin to the superior articular process it is then removed the cannulated foraminotomy sleeve with the stylus contained therein is advanced over the guide pin through the dilated channels through the soft tissues until it contacts the superior articular process at this point the guide wire is removed the central cannula stylus is then removed from the foraminotomy sleeve and the sleeve is then advanced under the oblique view toward the ventral direction of the superior articular process until the sleeve enters the foramen at the appropriate level during the procedure the patient is slightly sedated however conscious and able to respond to the surgeon 39 s verbal questioning at all times the patient maintains verbal confirmation with the surgeon and the anesthesia provider to ensure that the exiting nerve root.