Lumbar Epidural Steroid Injections: This common procedure is used to help alleviate low back and leg pain by reducing inflammation at a specific target area (i.e., nerve root, herniated disc, stenosis).
With a slight modification, this procedure can be used as a diagnostic tool for localizing the source of pain (selective spinal nerve block).
Cervical Epidural Steroid Injections: This procedure helps alleviate neck and arm pain by reducing inflammation at a specific target area (i.e. nerve root, stenosis).
Cervical, Thoracic and Lumbar Facet Joint Injections: This procedure consists of a localized intra-articular corticosteroid joint injection to help alleviate spine pain.
Medication is place directly into the joint, which is formed by two flat, bony surfaces linking the vertebrae together. This treatment is used for both diagnostic and therapeutic purposes.
Cervical and Lumbar Medial Branch Blocks: This procedure consists of a localized injection targeting the small sensory nerves (medial branches) innervating the adjacent facet joints.
Each facet joint has at least two medial branch nerves. This treatment is used as a diagnostic injection. A short or long acting local anesthetic is typically injected.
Cervical and Lumbar Medial Branch Neurotomy: This treatment is used in a select subset of patients who have an appropriate response to medial branch blocks. It provides a possible long term relief of spine pain.
Medication can be injected (chemical neurolysis). Commonly, heat (radiofrequency) or cold (cryoablation) are used to destroy part of the nerve near the accompanying facet joints. Special equipment is needed for the heat or cold neurotomy procedure.
Radiofrequency neurotomy is the most common type of neurotomy performed at Piedmont Spine Specialists.
Diagnostic and Therapeutic Hip Arthrogra: This procedure consists of a intra-articular hip joint injection to help diagnose and treat hip pain.
Contrast is injected to ensure proper placement of medication within the joint capsule. Local anesthetic -- with or without corticosteroid -- is commonly used.
Sacroiliac Joint Injections: Sarcoiliac (SI) joints are synovial joints formed by the articulation of the sacrum and pelvis. SI joints can be a source of buttock and lower back pain.
Studies have shown that pain from this joint can mimic sciatica symptoms. The use of fluoroscopy or CT is mandatory for this intra-articular injection.
Diagnostic and Therapeutic Shoulder Arthrogram: In this procedure, contrast is injected into the shoulder joint capsule to help diagnosis common rotator cuff pathologies. This treatment can be used in conjunction with MRI to help diagnose labral pathology.
This treatment is also useful in patients with previous rotator cuff repair. Anesthetic can be used to help identify the shoulder joint as the source of pain. Corticosteroids can be injected for possible therapeutic benefits.
Lumbar Discography: This is a diagnostic test used to help differentiate whether or not a disc is the source of pain.
Contrast is injected into at least two discs and patient's response is monitored. This is a common procedure performed prior to fusion surgery.
Additional Procedures Performed
Trigger Point Injections: Trigger points are a common source of muscle pain and spasms. Injecting these points can help relieve pain and spasms and increase range of motion.
Injections can be done in a series one to two weeks apart and this procedure is easily performed in the office.
Peripheral Joint Injections: This procedure is used to treat common inflammatory and degenerative processes. Corticosteroid and a local anesthetic are typically used.
Electromyography (EMG) and Nerve Conduction Studies (NCS): This is a physiologic test that measures muscle and nerve function.
This typically involves a two-part test that includes an electrical current (NCS) applied to the skin, which assesses how quickly impulses travel between nerves. Also, a fine needle electrode is placed in certain muscles to measure electrical activity (EMG).
This procedure is commonly used to assess entrapment neuropathies such as carpal and cubital tunnel syndromes, radiculopathies, and myopathies.