Spinal Procedures

Areas located along the spinal column including the low back (lumbar spine), mid back (thoracic spine), neck (cervical spine) and head can be treated with image-guided pain injections.

TMJ

The temporomandibular joint (TMJ) is between the mandible and the temporal bone in the skull. In this joint, the meniscus may become displaced, often due to an injury, and resulting in locking, or clicking of the jaw. This joint can become inflamed, or affected by osteoarthritis similar to other joints.
Injection of an anti-inflammatory steroid can be effective in relieving TMJ pain.

Greater/Lesser Occipital Nerves

An occipital nerve block is an injection of a steroid or other medication around the occipital nerves located on the back of the head just above the neck.

This reduces inflammation and swelling of tissue around the occipital nerves, which can in turn reduce pain or other symptoms caused by inflammation or irritation of the nerves and surrounding structures.  Typically many, but not all, types of headaches in the back of the head, including tension headaches and migraine headaches, respond well to occipital nerve blocks.

Botox for Chronic Migraine

BOTOX can be used to prevent headaches in adults with chronic migraine who have 15 or more headaches each month with a duration of 4 or more hours each day.

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Facet Injection

A facet injection involves the injection of cortisone into the cervical, thoracic, or lumbar facets to help  block pain. Facet joints are small joints along the spine, guiding motion and providing stability. Pain may develop due to back injury, arthritis of the spine, or other stresses to the back.

Medial Branch Block (MBB)

A medial branch nerve block is used to determine if the facet joints of the spine are causing back pain. Using fluoroscopic guidance and local anesthetic, the radiologist guides a needle toward nerve endings that create pain in the joints. An x-ray contrast is used to confirm placement of the needles and freezing is injected at these sites. The patient keeps a diary and records pain scores over the next 24 hours . These results determine the nature of the back pain and if the patient qualifies for an RFN.

Radiofrequency Neurotomy/Ablation  (RFN)

Radiofrequency Neurotomy is a procedure used to treat facet joint pain caused by degenerative changes or injury. Using fluoroscopic guidance and local anesthetic, the radiologist guides a needle toward nerve endings. The needle is then heated, creating a lesion to interrupt signals to the brain, effectively eliminating the pain.

Epidural Steroid Injection (ESI)

An Epidural Steroid Injection is an injection of cortisone around nerves to reduce inflammation and provide pain relief. The target area is numbed using local anesthetic and, using live x-ray, the needle is guided into the sac around the nerves. Dye is used to confirm placement before injecting a mixture of cortisone (steroid, anti inflammatory) and Marcaine, a local anesthetic.

Nerve Root Block (NRB)

An NRB is an injection of cortisone to a specific nerve. Similar to ESI, a local anesthetic is first used to numb the area. Using fluoroscopy, the needle is guided to the targeted nerve and X-ray dye confirms placement.  A mixture of cortisone and Marcaine (local anesthetic) is then injected..

SI Joints

An SI Joint injection involves the injection of cortisone into the sacroiliac joint next to the spine. Using fluoroscopy, the needle is guided to the targeted area.

Coccyx

A coccyx injection involves the injection of cortisone around the tailbone.