FAQ
What is Fluoroscopy?
Fluoroscopy is an imaging technique commonly used by physicians to obtain real-time moving images of the internal bony structures of a patient through the use of a fluoroscope. The images are projected on a monitor and can be used to guide a needle precisely toward a target spinal structure.
Epidural Steroid Block
What is it?
A needle is inserted into the epidural space
of the spine and anesthetic drugs or steroids are injected to confirm a diagnosis
of back pain from disc herniation or disruption and to decrease pain and inflammation.
What is the goal of epidural block?
To isolate the source
of back pain to the level of disc pathology and decrease pain from inflammation.
How is it done?
A local anesthetic is given in the skin.
A special needle is then inserted into the epidural space of the lumbar or
caudal spine. An anesthetic substance and/or steroid are injected into the
epidural space.
How is fluoroscopy used?
To guide the needle into the space
and to verify that it is in the correct position in the space. Contrast material
is given in the space to make the area visible on fluoroscopy and to outline
nerve roots.
Facet Injections
What is it?
Facet joints are located on each side of the
spine where one vertebrae slightly overlaps the adjacent vertebrae. The joints
guide and restrict movement of the spine. These joints have been identified
as a source of back pain.
What is the goal of the block?
To confirm that a facet joint
is the source of back pain and to decrease pain and inflammation in a facet
joint.
How is it done?
The patient is given a local anesthetic
in the skin. A needle is then inserted into the facet joint and an anesthetic
and steroid are injected.
How is fluoroscopy used?
To guide the needle into the joint
and to verify that it is in the correct position in the joint. Contrast material
is given in the joint to make it visible on fluoroscopy.
Discograms
What is it?
A diagnostic test performed to view and assess
the internal structure of a disc and determine if it is a source of back pain.
What is the goal of the block?
To confirm that a particular
disc is the source of back or leg pain.
How is it done?
The patient is given intravenous medication
as a relaxant and pain reliever. A local anesthetic is then injected into the
patient's skin. A needle is inserted through the skin and into the disc using
fluoroscopy. Saline solution and contrast are injected into one or more discs.
A CT scan is usually performed after the dye is injected to visualize the contrast
and emonstrate annular tears, scarring, disc bulges and changes in the nucleus
of the disc.
How is fluoroscopy used?
To guide the needle into the disc
and verify that it is in the correct position. Contrast material is given into
the disc to identify the pathology.
Stimulator Implants
What is it?
A spinal cord stimulator ("SCS") treats
pain by applying an electrical "stimulation" to the spinal cord.
This stimulation increases the nervous systems's ability to "turn down" pain
signals. An SCS consists of two parts: a wire placed next to the spinal cord
and a battery to supply the electrical stimulation. The battery and wire are
implanted under the skin. A "controller" can be placed over the battery
to turn the SCS on or off or increase or decrease the intensity of stimulation.
The controller does not have to remain over the battery for the SCS to operate.
An SCS allows a patient more control over his/her pain and does not have the
side effects associated with pain medication.
What is the goal?
To relieve back and leg pain through the use electrical stimulation of the spinal cord.How is it done?
Under general anesthesia an incision is made in the abdomen and a small subcutaneous pocket is created. The generator is inserted and then connected to a set of spinal cord stimulator leads that are placed in the low thoracic or cervical spine.How is fluoroscopy used?
Fluoroscopy is used to place the stimulator leads precisely in the epidural space.