Interventional Spine Procedures
- Epidural Steroid Injection
Epidural Steroid Injections are an effective
adjunct to treatment for patients with pain of spinal origin. Commonly, nerves
in the neck or back are compressed or irritated near the spine by a bulging or
herniated disc, a bone spur, or scar tissue. This causes the nerve to become
swollen, causing pain, numbness, tingling or weakness in the arms or legs. The
purpose of the epidural injection is to decrease inflammation and provide pain
relief, thereby facilitating active rehabilitation.
- Facet Joint Injection
Facet joint injections are used to treat pain
originating from the joints in the spine. The spine is full of joints (called
Z-joints or “facet” joints) which allow you to bend forward and back, or nod
your head. Like any other joint in the body, these joints have joint fluid and
cartilage that can develop arthritis or other painful conditions. Facet joint
injections are ways of diagnosing and treating pain coming from these joints.
- Medial Branch Block (MBB) Injection
Medial branch block injections are a diagnostic
procedure used to help diagnose the source of neck or back pain. The medial
branch nerves of the spine are tiny nerves whose primary function is to allow
sensation from the facet joints. There is a right and left facet joint at each
level of the spine. These joints can become painful in the same ways that knee,
hip, shoulder, or finger joints do. It is often very difficult to determine if
a particular joint is painful based only on MRI and physical exam, so medial
branch blocks (and sometimes facet joint injections) serve as diagnostic
procedures to help identify where the pain is coming from.
- Radiofrequency Ablation
Radiofrequency ablation is used for long term
pain relief of spine and sacroiliac joint pain. Facet joint injections, medial
branch blocks, and radiofrequency neurotomy are ways of diagnosing and treating
pain coming from joints in the spine.
- Sacroiliac Joint injection
A sacroiliac joint injection is a “cortisone
shot” for the sacroiliac joint. The sacroiliac joints are two joints (right and
left) which connect the lower spine or coccyx to the pelvis. These joints do
not move much, but they can become inflamed and painful, especially after
trauma. The only way to determine if a sacroiliac joint is causing pain is to fill
the joint with anesthetic and see if the pain disappears.
Trigger Point Injections:
- Trigger point injections are injections of
local anesthetic into trigger points in muscles. A trigger point is a palpable
band of muscle which is tender to pressure and palpation and may refer pain to
a nearby site. These injections are helpful in reducing or resolving persistent
muscle spasm and dysfunction.
Joint, Ligament and Bursa injections
- A variety of joint, bursa, or ligament
injections can be performed to assist in the reduction of pain and
inflammation. These injections are performed in the office using sterile
technique and ultrasound guidance to ensure accurate and safe needle placement.
Common injection sites include shoulders, knees, hips, wrists, and hands.
The use of ultrasound has drastically improved the safety and efficacy
of injection therapy for the treatment of a broad range of conditions. But that
is only the tip of the iceberg. A well-trained and experienced user can
differentiate between normal and abnormal nerve, blood vessel, bone, ligament,
tendons, bursae, and other soft tissue. This is key in making the correct
diagnosis. For example, when trying to determine whether shoulder pain is
coming from the rotator cuff which is outside the joint, or from arthritis
which is inside the joint, ultrasound can be used to investigate both of these
structures for signs of injury and inflammation. It can then be used to guide a
needle to exact area that needs treatment