SPINE

Cervical Spine Injection

Transforminal Epidural Steriod Injection

Medical Branch Block Injections

Vertebroplasty

The spine, also called the back bone, is designed to give us stability, smooth movement, as well as providing a corridor of protection for the delicate spinal cord. It is made up of bony segments called vertebrae and fibrous tissue called intervertebral discs.

Vertebral compression fractures, or VCF’s, occur when bones in the spine are broken. They can occur from trauma, such as a car accident or fall, but are most commonly the result of osteoporosis which causes weakened bones. VCF’s can also occur from other conditions that cause weakened bones, such as certain cancers or long term steroid use.

Compression fractures occur most commonly in the mid to lower back due to the weight bearing load of the spine. This load can cause weakened vertebrae to become crushed. Symptoms range from severe pain to no pain at all.

Compression fractures can lead to progressive spinal deformity. When multiple fractures occur, a condition known as Kyphosis, or dowager’s hump, causes the back to become rounded and bent forward which can affect quality of life making it more difficult to breathe, eat, walk, or sleep.

Vertebroplasty is an elective surgery to treat painful compression fractures of the spine that have not responded to conservative treatment measures such as rest, medication, or back bracing.

Facet Joint Injection

Facet joint injections contain a strong anti-inflammatory agent called corticosteroid and an anesthetic for pain relief. They are given to relieve pain in the back, neck, arm and leg and even headaches caused from inflammation of the facet joints.

Epidural Injection

Epidural injections contain a strong anti-inflammatory agent called corticosteroid and an anesthetic for pain relief. It is not the same as an epidural anesthesia given before birth to decrease labor pain. Epidural injections are given to relieve pain in the neck, back, arm and leg due to inflammation of spinal nerves from conditions such as spinal stenosis, spondylolysis, herniated disc, degenerative disc and sciatica.

Epidural injections are administered into the spine. The epidural space is the space between the outermost covering of the spinal cord (dura mater) and the wall of the spinal canal. It is approximately 5mm wide and is filled with spinal nerve roots, fat and small blood vessels.

NEUROLOGY

Occipital & Peripheral Nerve Blocks

The peripheral nervous system carries signals of movement and sensations such as heat, cold and pain from different parts of your body to the central nervous system formed by the spinal cord and brain. Injecting an anesthetic around a peripheral nerve can block the transfer of pain signals from the region it supplies to the brain. This is called a peripheral nerve block and can be used to manage chronic pain.

A common peripheral nerve block is the celiac plexus block. The celiac plexus is a bundle of nerves around the aorta that carry pain impulses from various abdominal organs.

The greater occipital nerve is a peripheral nerve that travels through the muscles at the back of the head and into the scalp providing sensation to the back and top of the scalp. A greater occipital nerve block involves injecting medication around the greater occipital nerve to relieve pain.

PAIN MANAGEMNET

Radiofrequency Ablation

Radiofrequency ablation (RFA), also called rhizotomy or neurotomy, is a novel non-surgical technique which employs radiofrequency waves to produce heat that damages the nerves transmitting pain signals to the brain.

Rhizotomy

Radiofrequency Rhizotomy is a minimally invasive procedure used to treat pain by sending radio waves through a needle to the selected medial branch nerves causing pain in order to interrupt the pain signals.

Medial branch nerves are very small nerves that innervate the facet joints of the spine. Facet joints are the joints connecting the different vertebra of the spine to each other. The joints are present on both sides of the spine from the neck to the lower back.