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Medial Branch Block
A medial branch nerve block is a procedure in which an anesthetic is injected near small medial nerves connected to a specific facet joint. Typically several levels of the spine are injected in one procedure.
If the patient experiences marked pain relief immediately after the injection, then the facet joint is determined to be the source of the patient’s pain.
The procedure is primarily diagnostic, meaning that if the patient has the appropriate duration of pain relief after the medial branch nerve block, then he or she may be a candidate for a subsequent procedure called a medial branch radio frequency neurotomy (or ablation) or Bone Marrow Aspiration for a stem cell injection procedure for longer term pain relief.
Facet Joint InjectionsFacet joints are surrounded by a joint capsule made up of synovial membrane tissue. This joint capsule contains a rich innervation of nerves and its upper pad is typically fused with the fatty sheath of the spinal nerve. When the synovial membrane tissue of the joint capsule is inflamed, facet joint injections may:
Epidural Steroid Injections (ESI)An epidural steroid injection is a minimally invasive procedure that can help relieve neck, arm, back, and leg pain caused by pinched or inflamed spinal nerves due to stenosis or disc herniation. Medicines are delivered to the epidural space, which is a fat-filled area between the bone and the protective sac of the spinal nerves. Pain relief may last for several days or even years. The goal is to reduce pain so that you may resume normal activities and a physical therapy program. Patients with pain in the neck, arm, low back, or leg (sciatica) may benefit from ESI. Specifically, those with the following conditions:
- Spinal stenosis
- Herniated disc
- Degenerative disc
Anterior Cervical Discectomy & Fusion (ACDF)Anterior cervical discectomy and fusion is a surgery to remove a herniated or degenerative disc in the neck. An incision is made in the throat area to reach and remove the disc. A graft is inserted to fuse together the bones above and below the disc. ACDF may be an option if physical therapy or medications fail to relieve your neck or arm pain. Patients typically go home the same day.
Spinal Fusion: Lateral Lumbar lnterbody Fusion (LLIF)
Lateral interbody fusion is a minimally invasive surgery to treat disc problems in the low back. In spinal fusion, two or more bones of the spine are joined to stop painful motion, decompress pinched nerves, and correct scoliosis. Through a small incision at the side of the waist, the disc is removed and a bone graft is inserted to restore the height and relieve nerve pinching. During healing, the bones fuse into one solid piece.
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