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- Sphenopalatine Ganglion Block
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- Intra-articular Injections
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- Implanted Epidural Portal
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What is Epidural Steroid (cortisone) Injection ?
Epidural glucocorticoid injections are commonly given to patients with leg and/or back pain to relieve such pain and improve mobility without surgery. These steroid injections buy time to allow healing to occur and/or as an attempt to avoid surgery after other conservative (non-surgical) treatment approaches have failed.
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What is a Facet Joint pain syndrome? |
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Facet joints are joints between two vertebral bones. They are
arranged in the back part of your spine from the neck all the way
down to your low back. They can be painful due to “whiplash”
injuries of the neck, arthritis or degeneration in the low back.
These joints may cause pain in and around the spine and can
markedly limit how you use your neck or back.
When facet joints are painful, it can be difficult to bend the
spine backward / sideways.
Each facet joint is served by medial branch nerves, and if these
nerves are blocked with local anesthetic, the pain from the joints
will stop.
This is the only test to tell the doctor the pain is coming from
facet joint.
Once test is positive (i.e. you get more than 50%pain relief),
radiofrequency ablation of medial branches will provide your
lasting pain relief.
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Facet Joints -
Lumbar
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in Facet joint |
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What is
Radiofrequency Neuroablation ?
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Radiofrequency ablation
or lesioning is a term used when radio waves
are used to produce heat to destroy tissue, usually a
nerve.
It is a non-surgical option to
treat your spine pain. In the case of spinal pain,
radiofrequency waves are transmitted through a needle placed
near the nerve under x-ray guidance. This procedure is also
known as
RF rhizotomy.
Radiofrequency ablation therapy
is one of the best procedure available till today to provide
long lasting pain relief. It is very safe, done under local
anesthesia, & usually requires few hours at the pain clinic. |
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What is Provocative Lumbar
Discography ?
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When pain in
the low back does not respond to the basic treatments it
may be necessary to investigate the intervertebral discs
as possible pain generating structures.
Painful discs
can be bulging or have tears, but often discs that look
normal on X-rays or MRI may be painful.
The procedure
usually takes about 30 minutes.
A small
needle is guided into the center of the discs and dye is
injected while X-rays are being taken and intra disc
pressure is measured.
The disc is
said to be a cause of pain, if injections produces pain
which is same as your usual pain.
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Disc
herniation
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What are Intradiscal Procedures ? |
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Dekompressor Discectomy -
This is very
effective for low back pain or leg pain where disc is proven
as cause of pain by MRI scan or discography.
A thin (few mm)
wand/needle like device is inserted in the disc under local
anesthetic.
The disc nucleus
material is removed by to & fro movement of the wand in different
direction under live x-ray control. This decompresses the disc &
relieves pain.
The pain relief is
almost immediate in most of the patients & some gets relief within
4-6 weeks depending on the chronicity of the case.
It is one of the very
rewarding procedure in small contained disc herniation &
usually avoids the need for major back surgery.
The procedure takes
30-40 minutes & patients can go home within few hours after the
procedure.
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Ozone Discectomy – |
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A simple procedure to get pain
relief for disc herniation or degenerative disc disease.
It involves insertion of the thin
needle in the disc & injection of ozone (produced by
specialized ozone generator).
The action of ozone is due to the
active oxygen atom liberated from breaking down of ozone
molecule. When ozone is injected into the disc, the active
oxygen atom called the singlet oxygen or the free radical
attaches with the proteoglycan bridges in the jelly-like
material or nucleus pulposus.
They are broken down and they no
longer capable of holding water. As a result disc shrinks
and mummified and there is decompression of nerve roots.
It is almost equivalent to
surgical discectomy and so the procedure is called ozone
discectomy or ozonucleolysis.
Besides, it has an
anti-inflammatory action due to inhibitions of formation of
inflammation producing substances, tissue oxygenation is
increased due to increased 2,3 diphosphoglycerate level in the
red blood cells.
All these leads to decompression
of nerve roots, decreased inflammation of nerve roots,
increased oxygenation to the diseased tissue for repair work. |
X-ray Picture of needle in
the disc for Ozone therapy |
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