Interventional Pain Center Services

A facet joint injection is a relatively simple, straightforward procedure, and is usually performed in an office-based procedure suite or an ambulatory surgical center. As with many spinal injections, facet joint injections are best performed using fluoroscopy (live X-ray) for guidance to properly target and place the needle (and to help avoid nerve injury or other injury).

Vertebroplasty and kyphoplasty are minimally invasive procedures for the treatment of painful vertebral compression fractures (VCF), which are fractures involving the vertebral bodies that make up the spinal column. When a vertebral body fractures, the usual rectangular shape of the bone becomes compressed, causing pain. These compression fractures may involve the collapse of one or more vertebrae in the spine and are a common result of osteoporosis.

Osteoporosis is a disease that results in a loss of normal bone density, mass, and strength, leading to a condition in which bones become increasingly porous and vulnerable to breaking easily. Vertebrae may also become weakened by cancer. For vertebroplasty, physicians use image guidance, typically fluoroscopy, to inject a cement mixture into the fractured bone through a hollow needle. During kyphoplasty, a balloon is first inserted into the fractured bone through the hollow needle to create a cavity or space. The cement is injected into the cavity once the balloon is removed.

Cervical disc replacement is a surgical procedure that involves removing a damaged or degenerated cervical disc and replacing it with an artificial disc device. Cervical discs are the cushions or shock absorbers between the bones (vertebra) of the neck (cervical spine). Discs that become damaged either through trauma or degeneration can be a source of pain.

If part of a disc moves out of its normal position it can cause pressure on the central spinal cord or on the individual nerve roots that exit from the spinal canal at each vertebral level.

For patients with more serious spinal disorders, vertebrae fusion is required to immobilize the joints and stabilize the spine. Pedicle screws have been used to fuse vertebrae for a long time, but now this can be done with a “percutaneous” procedure. Instead of an open surgery, very small incisions are made in the skin. The surgeon uses X-ray fluoroscopic imaging to guide the placement of the special screws into the vertebrae.

The surgeon then attaches a rod to connect the pedicle screws, stabilizing the spine. This procedure is considered minimally invasive compared to traditional open surgery that splits and retracts the muscle of the spine through a much larger incision.