FAQ

What is Fluoroscopy?

Fluoroscopy is an imaging technique commonly used by physicians to obtain real-time moving images of the internal bony structures of a patient through the use of a fluoroscope. The images are projected on a monitor and can be used to guide a needle precisely toward a target spinal structure.

Epidural Steroid Block

What is it?
A needle is inserted into the epidural space of the spine and anesthetic drugs or steroids are injected to confirm a diagnosis of back pain from disc herniation or disruption and to decrease pain and inflammation.

What is the goal of epidural block?
To isolate the source of back pain to the level of disc pathology and decrease pain from inflammation.

How is it done?
A local anesthetic is given in the skin. A special needle is then inserted into the epidural space of the lumbar or caudal spine. An anesthetic substance and/or steroid are injected into the epidural space.

How is fluoroscopy used?
To guide the needle into the space and to verify that it is in the correct position in the space. Contrast material is given in the space to make the area visible on fluoroscopy and to outline nerve roots.

 

Facet Injections

What is it?
Facet joints are located on each side of the spine where one vertebrae slightly overlaps the adjacent vertebrae. The joints guide and restrict movement of the spine. These joints have been identified as a source of back pain.

What is the goal of the block?
To confirm that a facet joint is the source of back pain and to decrease pain and inflammation in a facet joint.

How is it done?
The patient is given a local anesthetic in the skin. A needle is then inserted into the facet joint and an anesthetic and steroid are injected.

How is fluoroscopy used?
To guide the needle into the joint and to verify that it is in the correct position in the joint. Contrast material is given in the joint to make it visible on fluoroscopy.

 

Discograms

What is it?
A diagnostic test performed to view and assess the internal structure of a disc and determine if it is a source of back pain.

What is the goal of the block?
To confirm that a particular disc is the source of back or leg pain.

How is it done?
The patient is given intravenous medication as a relaxant and pain reliever. A local anesthetic is then injected into the patient's skin. A needle is inserted through the skin and into the disc using fluoroscopy. Saline solution and contrast are injected into one or more discs. A CT scan is usually performed after the dye is injected to visualize the contrast and emonstrate annular tears, scarring, disc bulges and changes in the nucleus of the disc.

How is fluoroscopy used?
To guide the needle into the disc and verify that it is in the correct position. Contrast material is given into the disc to identify the pathology.

 

Stimulator Implants

What is it?
A spinal cord stimulator ("SCS") treats pain by applying an electrical "stimulation" to the spinal cord. This stimulation increases the nervous systems's ability to "turn down" pain signals. An SCS consists of two parts: a wire placed next to the spinal cord and a battery to supply the electrical stimulation. The battery and wire are implanted under the skin. A "controller" can be placed over the battery to turn the SCS on or off or increase or decrease the intensity of stimulation. The controller does not have to remain over the battery for the SCS to operate. An SCS allows a patient more control over his/her pain and does not have the side effects associated with pain medication.

What is the goal?
To relieve back and leg pain through the use electrical stimulation of the spinal cord.

How is it done?
Under general anesthesia an incision is made in the abdomen and a small subcutaneous pocket is created. The generator is inserted and then connected to a set of spinal cord stimulator leads that are placed in the low thoracic or cervical spine.

How is fluoroscopy used?
Fluoroscopy is used to place the stimulator leads precisely in the epidural space.