Back Pain/Neuro Imaging

Interventional Pain Treatment Options

Injections

There are many conditions that require injections around the nerves or into the joints with medication to obtain relief of pain, whether it is a local anesthetics or a steroid medication utilized.

Epidural Injections

The epidural space is an area that is around the spinal fluid sac and typically contains only blood vessels and fat. This injection procedure is done on an “outpatient” basis with the whole procedure usually lasting less than 15 minutes. Typically, the injection is done under X-Ray guidance with the patient in the prone (face down) position. A combination of steroid and long acting numbing medicine is injected. Usually, a small amount of x-ray contrast (dye) is used to further confirm the correct position of the needle prior to the injection of the medicine. These injections are usually targeted at the side of the pain and can also be called trans-foraminal steroid injections.
Facet Injections

The facet joints are small joints at the back of the spine that support and aid in rotation and bending of the spine. The facet joints give the spine its flexibility. Sometimes these joints can become inflamed from either trauma or arthritis. Injection of a facet joint is always done under x-ray (fluoroscopy) to correctly place the needle into the small joint space. A combination of steroid and long acting numbing medicine is injected. A small amount of x-ray contrast (dye) may be injected to further confirm the correct position of the needle prior to the injection of the medicine.

Nerve Blocks

Blocks are injections of medication onto or near nerves. The medications that are injected include local anesthetics, steroids and opioids. If a steroid is injected along with a local anesthetic, this can reduce pain in the nerve if the pain is caused by inflammation or irritation of the nerve. Blocks are used to control acute pain, reduce nerve and joint inflammation and often as a diagnostic tool to determine the source of the pain.

Sacroplasty

Sacroplasty is a pain treatment for sacral insufficiency fractures that fail to respond to conventional medical therapy, such as limited pain relief with analgesics or narcotic doses that are intolerable.  Sacroplasty, a nonsurgical treatment performed by a Neuroradiologist using imaging guidance, stabilizes the sacral fractures with the injection of medical-grade bone cement into the sacrum.  The cement hardens in about one hour and patients are usually discharged in two hours.  Pain is significantly reduced or eliminated in 80-90% of patients.

Vertebroplasty

85% of compression fractures due to porosis cause pain, often severe enough to limit activity or cause forced bed rest, which can further cause porosis and bone loss.  Vertebroplasty is a pain treatment for vertebral compression fractures that fail to respond to conventional medical therapy, such as limited pain relief with analgesics or narcotic doses that are intolerable. Vertebroplasty, a nonsurgical treatment performed by a Neuroradiologist using imaging guidance, stabilizes the vertebral compression fracture with the injection of medical-grade bone cement into the vertebral body.  The cement hardens in about one hour and patients are usually discharged in two hours.  Pain is significantly reduced or eliminated in 80-90% of patients.

Patient Education

Post myelogram instructions