Conditions & Services

Radiofrequency Ablation

RFA or Radiofrequency Ablation is sometimes used to treat severe chronic pain in the low back (lumbar) and neck (cervical) regions of the spine. Radiofrequency waves are used to produce heat on specifically identified sensory nerves surrounding the facet joints on either side of the lumbar or cervical spine. By generating heat on specifically identified sensory nerves, its ability to transmit pain signals to the brain is disrupted. An intravenous line may be inserted to administer a mild sedative. RFA is a minimally invasive procedure which is usually done in a day surgery clinic and the patient is sent home shortly after completion of the procedure. Patients can experience pain relief for six to 24 months following RFA. This procedure can be repeated if necessary.

Transforaminal Epidural Steroid Injection

A transforaminal injection is a long acting steroid delivered into a nerve root exit in the spine known as a foramen. The injection helps to reduce inflammation and swelling in the spinal cord nerve roots and relieves pain and numbness. A transforaminal injection consists of a small dosage of steroid medication mixed with saline and local anesthesia. The anesthesia numbs the area so the injection often feels like just pinching and pressure.

Immediate pain relief is found because of the injection of anesthesia, but this wears off quickly. Effective relief is usually noticeable by the third day after the injection and can last for several months. This treatment is most successful for patients with pain that radiates through the arms or legs rather than just back or neck pain.

Trial for Spinal Cord Stimulator

A spinal cord stimulator is an electronic device that is implanted in the body to help relieve chronic pain. Also known as a dorsal column stimulator, the device sends low electrical currents through wires placed near the spinal cord, allowing patients to control when pain relief is offered.

The device does not cure chronic pain, but usually provides a 50% or greater decrease in pain and allows patients to be more active and require less pain medication. This procedure is usually considered when other solutions, such as surgery, injections and medications, have failed. Before implantation, patients will often be asked to go through a trial period with an external device. The trial will test patients’ pain levels and see if they improve with the help of the device.

During the implantation of the permanent device, wires are fed with a needle and positioned on the spinal cord. Placement of the device is dependent on the site of the pain. The device can be removed if necessary. The battery of the device must be replaced every 2 to 5 years. Proper care following the procedure is required and includes limiting movement and avoiding driving for the first few weeks.

Vertebral Augmentation

Kyphoplasty

Kyphoplasty is a minimally-invasive procedure to relieve pain from vertebral compression fractures, affecting the bones from which the spinal column is comprised. This procedure is usually performed on patients whose vertebral fractures have occurred as a result of osteoporosis. For best results, kyphoplasty should be performed within two months of the fracture’s occurrence.

Kyphoplasty is performed as an outpatient procedure under sedation, although general anesthesia may also be used; therefore, you will need a friend or relative to drive you home afterward. You will be lying facedown for the duration of the procedure, which lasts around an hour. Once the sedative and/or general anesthesia has taken effect, the skin surrounding your spine will be sterilized and shaved, and a tiny cut will be made in the area. With x-ray assistance, an empty needle known as a trocar will be inserted into the spine until its tip is positioned evenly with the fractured vertebra. A balloon is then inserted though the needle and inflated, reverting the bone to its original shape and creating a cavity. The balloon is then removed and orthopedic cement is injected into the area, filling the cavity. Finally, the trocar is removed, pressure is applied to stop bleeding, and a bandage is placed around the skin.

Vertebroplasty

Vertebroplasty is a minimally invasive procedure used to treat vertebral compression fractures (VCF), which are fractures of the vertebra that commonly occur as a result of osteoporosis, spinal tumors or injury, and can cause severe pain and limited mobility. They can also lead to abnormal spine curvature and increase a patient’s risk for serious spinal complications.

In many cases, vertebral fractures can be treated through conservative methods such as bed rest, a back brace or pain medication. However, patients with osteoporosis or whose fractures have caused severe, long-term pain may benefit from a minimally invasive procedure such as vertebroplasty to relieve symptoms. This procedure is also recommended for patients who are too weak to undergo spinal surgery, or have a malignant tumor within the spine that has caused vertebral damage. Vertebroplasty is most effective when performed on fractures that are less than six months old.

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