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Services
Treatment Options
The type of treatment will depend on the particular pain syndrome and each individual's response to that pain. Medications, nerve blocks, physical therapy and counseling are frequently combined to address the pain from multiple avenues. State-of-the-art techniques such as: spinal cord stimulation, implanted spinal drug delivery systems, cryo-analgesia, radiofrequency ablation, IDET (intradiscal electrothermal therapy), and myeloscopy are available in appropriately selected cases.
Most procedures are performed on an outpatient basis, in either our office or a one-day surgery setting. Radiologic guidance is often used to accurately and precisely obtain correct needle position. Sedation is provided for operating room procedures upon request to provide improved patient comfort and acceptance.
Cervical Epidural Steroid Injection
Discography
Facet Joint Injections
Intradiscal Electrothermal Therapy (IDET)
Intrathecal Pump Implant
Lumbar Epidural Steroid Injection
Lumbar Radiofrequency Neurotomy
Lumbar Sympathetic Block
Lumbar Transforaminal Epidural Steroid Injection
Medial Branch Block
Percutaneous Disc Nucleoplasty
Percutaneous Laser Discoplasty
RACZ Caudal Neurolysis
Sacroiliac Joint Steroid Injection
Spinal Cord Stimulator Implant
Stellate Ganglion Block
Percutaneous Discectomy (PLDD, LASE, Coblation)
Percutaneous Discetomy is a minimally invasive spine surgical technique designed to treat pain arising from a disc herniation. In this procedure, the disc herniation is decompressed through a needle or cannula without the need for open surgery (NO incision.) This treatment is highly effective and recovery time is quick, reducing time out of work. There are several possible techniques available, which one to use is based on the size and location of the disc herniation.
Spinal Cord Stimulation (SCS)
Spinal cord stimulation works by preventing perception of pain at the spinal cord level. Placing wire electrodes into the epidural space stimulates the spinal cord resulting in a pleasant, tingling sensation, masking the pain. SCS is useful in condition such as chronic back and leg pain following spine surgery, peripheral vascular disease, reflex sympathetic dystrophy (RSD), phantom limb pain, intractable angina and other pain syndromes.
Intradiscal Electro Thermal Therapy (IDET)
IDET is a minimally invasive treatment for pain arising from degenerative disc disease. Controlled levels of thermal energy (heat) are applied to the area of the disc wall associated with pain production. IDET is not effective for large disc herniation, but will seal disc wall tears and reduce the size of small disc bulges/herniations.
Implanted Spinal Drug Delivery System
(Intrathecal Opioid Infusion Device)
Involves placing a soft catheter into the spinal fluid and attaching it to a surgically implanted pump. Patients are tested with a temporary external system to help predict long-term response and ensure patient tolerance of this technique. Spinally administered opioids are an option for patients that develop side effects to oral medications and/or who fail to respond to more conservative injection therapies.
Radiofrequency Denervation (RF)
RF is used to selectively destroy nerve tissue from which pain originates. First a diagnostic injection of local anesthetic is performed to identify the pain generator and to provide outcome prediction. Then electrical current is used to interrupt nerve conduction and prevent the patient from feeling pain. RF usually provides 1-2 years of pain relief (until the nerve regenerates) during which time the body may heal itself to prevent pain recurrence.
Patient Education
Spine Anatomy
About Cervical Radiculopathy
About Facet Joint Syndrome (Arthritis)
About Herniated Discs
About Lumbar Radiculopathy (Sciatica)