cutting-edge techniques and procedures

ESIs utilize a long-acting steroid to treat disc herniations(link), forminal stenosis(link), lateral disc herniations and bulges, and leg pain. This injection is also used to identify a specific spinal nerve root level or levels that are the source of the pain. During the procedure, a steroid is injected directly into the foramen, where the nerve root exits, which decreases inflammation and improves mobility

Facet joints are small joints at each segment of the spine that provide stability and help guide motion. The facet joints become painful due to spinal injury, mechanical stress to the spine, and/or arthritis. There are three types of facet joints. Cervical facet joints cause pain to the head, neck, shoulder, and/or arm. Thoracic facets cause pain to the upper back. Lumbar facet pain is usually felt in the lower back, hip, buttock, and/or leg. During the procedure, a local anesthetic is used to reduce pain and then a steroid injection is placed directly into the facet joint or medial branch. In addition to pain relief by decreasing the inflammation in the joint, these injections are used to diagnostically determine if the facet joints are the cause of the pain.

The SI joints lie next to the spine and connect the sacrum with the pelvis. Most of the motion in the area of the pelvis occurs either at the hips or the lumbar spine. These joints support the entire weight of the upper body when we are standing, which places a large amount of stress across them sometimes leading to wearing of the cartilage of the SI joints and arthritis. A combination of mild and a local anesthetic is used to decrease pain. Then, a real-time x-ray (fluoroscopy) is used to pinpoint the exact location for the injection of a steroid into the SI joint to decrease inflammation. The duration of pain relief from an SJI can last from one day to multiple months and can be repeated each month with up to three each year.

RFA is a minimally invasive procedure used to treat facet joint pain and SI joint pain caused by injury, arthritis, or other degenerative changes. For the procedure, mild sedation is administered to relax the patient and local anesthetic numbs the area to be treated. A needle and electrode is inserted and a high frequency electrical current is passed through the electrode to heat up and lesion the sensory nerve. This process creates a heat lesion on the nerve, which interrupts the pain signal to the brain, thus eliminating pain.

Age-related wear and tear of the intervertebral disc can cause loss of hydration and degeneration. VIA Disc is the first and only nonsurgical Nucleus Pulposus (NP) allograft intended to replace a patient’s tissue loss due to intervertebral disc degeneration. VIA Disc NP is delivered into the degenerated intervertebral disc through a small needle. The treatment is designed to mimic native, healthy nucleus pulposus (80% water content) and after delivery, VIA Disc NP supports the natural cushioning function and supplements tissue loss in the degenerated intervertebral disc.

An SCS is used to treat chronic pain. A small device called a spinal stimulator is planted under the skin, and thin and flexible “leads” are connected to the stimulator and placed near specific nerves in the back. The SCS sends mild pulses through the leads to the nerves; the pulses interrupt the pain signals on the way to the brain.

PNS can help with pain in the lower back, shoulder, head and neck, knee, and ankle/foot. PNS is a low-risk, non-surgical treatment that uses a minimally invasive procedure to place an implant that blocks pain for up to 60 days without the need for permanent implantation of hardware.

Trigger Points are focal areas of spasm and inflammation in the skeletal muscle. The area is tender and often has a palpable nodule in the muscle where the trigger point is located. Acute trauma or repetitive minor injury can lead to the development of a trigger point. During this procedure, a local anesthetic and steroid is injected directly into the trigger point to reduce pain and inflammation.