Pain Management

Surgical Procedures

In the most serious cases, when the pain does not respond to other therapies, surgery may relieve pain caused by back problems or serious musculoskeletal injuries. Some surgical procedures may be performed in a doctor’s office under local anesthesia, while others require hospitalization.       

• Lumbar Microdiscectomy (microdecompression): Discectomy is one of the more common ways to remove pressure on a nerve root from a bulging disc or bone spur. During the procedure the surgeon takes out a small piece of the lamina (the arched bony roof of the spinal canal) to remove the obstruction below.    
• Vertebroplasty:  Vertebroplasty is a procedure to treat painful compression fractures of the spine.  This procedure involves the injection of bone cement into the vertebral fracture.  Vertebroplasty can result in a dramatic decrease in pain as well as stabilizing the compression fracture and allowing a return to normal activities.
• Lumbar & Cervical Radiofrequency Ablation : Radiofrequency lesioning is a procedure using electrical impulses to interrupt nerve conduction (including the conduction of pain signals) for 6 to12 months. Using x-ray guidance, a special needle is inserted into nerve tissue in the affected area. Tissue surrounding the needle tip is heated for 90-120 seconds, resulting in localized destruction of the nerves.     
• IDET: IntraDiscal Electrothermal Therapy (IDET) uses thermal energy to treat pain resulting from a cracked or bulging spinal disc. A special needle is inserted via a catheter into the disc and heated to a high temperature for up to 20 minutes. The heat thickens and seals the disc wall and reduces inner disc bulge and irritation of the spinal nerve.     
• Intrathecal Pump Implants (ITP’s) are devices that deliver pain medicine to the pain receptors in the spinal cord to relieve chronic pain.  This is accomplished by implanting a device under the skin in the lower abdomen.  The device is attached to a catheter that is placed under x-ray guidance in the intrathecal space of the spinal cord.     
• Spinal Cord Stimulator Implants:  This implantable device is used to treat chronic pain through the use of electrical impulses.  This is accomplished by implanting a device under the skin that delivers low electrical impulses through a wire lead to the source of pain in the spinal cord.  The impulses block the perception of pain to the brain and the patient instead feels a mild tingling sensation.