Spinal procedures are minimally invasive injections used to treat or diagnose various conditions that cause pain and impaired function in the back, neck, shoulders, arms, buttocks and legs. Spinal procedures are a conservative treatment option to manage pain in lieu of back surgery, or when the patient is not a candidate for surgery. CROM physicians perform spinal procedures to all levels of the spine; Cervical, Thoracic, and Lumbar. Our injectionist physicians are board-certified in Physical Medicine & Rehabilitation, and perform spinal procedures under the safety of fluoroscopic guidance in a surgical suite. CROM performs the following spinal procedures:
Epidural Steroid Injections
Epidural Steroid Injections are used to treat symptoms of radiculopathy and sciatica. Radiculopathy can be caused by Stenosis, the narrowing of the openings through which nerves exit the spine. Stenosis can exert pressure on the nerves of the spine, which can cause pain in many parts of the body. Stenosis can be caused by herniated disc (bulging disk), degenerative disc disease, and arthritis.
Epidural Steroid Injections deliver low doses of long-lasting corticosteroids directly to the source of the pain. Corticosteroids are potent anti-inflammatory pain medications that reduce the swelling caused by stenosis, thereby reliving pressure on the nerves, and relieving pain.
Facet Joint Injections/ Medial Branch Blocks
The small joints of the spine, which support the body when bending, flexing and twisting, are called facet joints. Like all joints in the body, they can become injured or arthritic, and can produce chronic and acute pain known as facet syndrome. Facet Joint Injections deliver low doses of long-lasting corticosteroids directly to the source of the pain around the nerves to reduce inflammation and manage pain.
Medial Branch Nerves feed out from the spine around the facet joints. Inflamed facet joints can cause pain in these nerves. A Medial Branch Block is a diagnostic procedure that delivers temporary anesthetic to the Medial Branch Nerve suspected of generating pain. If the patient experiences immediate relief of pain following the Medial branch Block, then the source of pain has been identified, and a Facet Joint Injection or Radiofrequency Neuro Ablation may be performed to achieve long-lasting pain management.
Selective Nerve Root Blocks
Selective Nerve Root Blocks deliver anesthetic to a pain generating nerve. They can either be diagnostic, or therapeutic.
Radiofrequency Neuro Ablation (Rhizotomy)
Radiofrequency Neuro Ablation uses high frequency radio waves to heat the tip of a specialized needle which is precisely applied to a pain generating Medial Branch Nerve. The heat interrupts the nerve’s ability to send pain signals, which effectively “turns it off”, giving the patient long-term relief from the pain.
Occipital Nerve Blocks
An Occipital Nerve Block is an office-based injection used to treat various types of headaches, including migraines. Local anesthetic with or without a small dose of corticosteroid may be used, which is administered to the back of the head.
Sacroiliac Joint Injection
The Sacroiliac Joint is where the spine joins the pelvis. An inflamed Sacroiliac Joint can cause pain in the low back as well as the groin, abdomen, hip, buttock or leg. An injection containing anesthetic or low doses of long-lasting corticosteroids can manage the pain.
Discography (Discogram)
This is a diagnostic procedure used to determine your source of pain. Under live fluoroscopic guidance, the Discography injects a small amount of dye into an intervertebral disc, which then exposes structural damage in the disc. Discography is often ordered by spine surgeons for surgery planning.
Spinal Cord Stimulator Trials
A Spinal Cord Stimulator is a small implanted device that sends electrical surges to the spinal cord through electrodes to manage pain in the back. The stimulator consists of several small components, including a battery that lasts up to 10 years, which can be passively recharged. The patient self-adjusts an external remote to control the strength of the stimulator. CROM performs Spinal Cord Stimulator Trials, where the electrodes are inserted to the area of pain for a short period of time, before the actual device is surgically implanted.
For what conditions can Spinal Procedures treat/diagnose pain?
- Herniated Disc
- Degenerative Disc Disease
- Sciatica
- Facet Syndrome
- CRPS (Chronic Regional Pain Syndrome)
- Radiculopathy
- Facet Joint Arthritis
- Hip Joint Arthritis
- Sacroiliac Joint Dysfunction
- Chronic Back Pain
- Migraine Headache
How should you prepare for your Spinal Procedure?
Please do not eat or drink anything 8 hours prior to your injection. If you have any questions regarding taking your medications the day of your procedure, please call our office prior to your appointment so that we can check with the physician.
Please make arrangements to have someone available to drive you home after your injection. This is to ensure your ultimate safety and comfort following your procedure. It is our policy not to perform a spine procedure if a patient has not arranged for transportation home.
Children are prohibited from being present in the procedure room. Please make necessary child care arrangements in advance of your appointment.
Please notify the CROM physician performing your procedure if you have any allergies to medications.
What to expect from the Spinal Procedure:
All procedures are performed in a surgery center setting. The procedure itself usually takes 20-40 minutes, but each center has different policies regarding checking in and post-procedure monitoring. You will be placed in a gown and have intravenous (IV) access obtained. You will be brought into a procedure room, positioned properly, and you may be given light conscious sedation if necessary. You will be monitored by a nurse or a nurse anesthetist throughout the procedure. Once you are properly positioned, your physician will perform your interventional spine procedure. You may feel some pressure in your spine during your injection. We will continue to monitor you after your procedure. You will be advised on ways to diminish any soreness or discomfort you may feel after your procedure. Once the monitoring period is completed, you are free to leave. You are advised to eat within an hour or two after your procedure. Our office will contact you the day after your injection to check on you.