Special Procedures
EPIDURAL NEUROPLASTY
The Epidural Neuroplasty (Lysis of Adhesions) procedure is a highly specialized conservative technique in the management of back and leg pain. It is highly effective in a wide variety of conditions, such as Disc Herniations, Nerve Root Compression, Spinal Stenosis, Radiculopathies, Epidural Scarring, Post Laminectomy Syndrome, Facet Pain and Myofascial Pain Syndromes.
The beauty of the Epidural Neuroplasty technique rests in the precise targeting of the suspected pain generator by using an X-ray guided catheter technique. The catheter can be directed over a wide area of the epidural space at multiple levels, directed to precise disc level, or precisely onto nerve roots. Success rests in the ability to place the catheter as close to the target and can be affected by anatomic considerations.
The success rate of catheter technique is significantly higher than standard epidural techniques because X-ray guidance is utilized guaranteeing optimal placement of medications. Standard Epidural techniques have been known to fail because of incorrect placement. Failure is also due to the spread medication, which is usually to the area of least resistance to flow, that may not be the pain-generating site. Overall success is very high; sometimes it requires a series of injections and maintenance therapy.
DISCOGRAM STUDY
A Provocative Discogram Study is a diagnostic study designed to evaluate if the patient has pain from the disc which levels are involved in pain generation, how severe the pain is at the levels involved, the anatomy of the disc itself and whether there is leakage or extrusion of disc material into the epidural space or other locations
Identifying the location of the Pain Generator is crucial to Medical, Chiropractic, Pain Management and Surgical treatment. This valuable information will guide treatment in the most efficient and cost effective manner. Additionally it may give the patient the answer as to why there is such severe pain and disability
PERCUTANEOUS DISCECTOMY PROCEDURE
The Percutaneous Discectomy procedure is an excellent alternative to Open Surgical Discectomy for the qualified candidate. Percutaneous Discectomy is a minimally invasive procedure for disc decompression and pain relief.
The Percutaneous Discectomy Procedure is a safe, effective and well tolerated out patient procedure. It is a highly cost effective procedure. Many patients receive excellent, immediate relief. Patients who have continued persistent pain, or with progressive disc disease or protrusions may be candidates for Nucleoplasty procedures but in some cases these patients may require open surgical treatment. The Nucleoplasty procedure does not preclude the patient from having the more invasive surgical procedure, thus the option remains open. The choice of a less invasive procedure such as Percutaneous Discectomy may prevent many of our surgical failures and avoid the dreaded Post Laminectomy Syndrome diagnosis.
VIDEO EPIDUROSCOPY PROCEDURE
The Video Epiduroscopy Neuroplasty (Lysis of Adhesions) Procedure is a highly specialized conservative technique in the management of back and leg pain. It is highly effective in a wide variety of conditions, such as Disc Herniations, Nerve Root Compression, Spinal Stenosis, Radiculopathies, Epidural Scarring, Post Laminectomy Syndrome, Facet Pain and Myofascial Pain Syndromes. The beauty of the technique rests in the precise targeting of the suspected pain generator by using an Epidural X-ray guided catheter technique and direct visualization using Fiberoptic technology. The catheter can be directed over a wide area of the epidural space at multiple levels, directed to precise disc level or precisely onto nerve roots.
Success rests in the ability to place the catheter as close to the target and can be affected by anatomic considerations. The success rate of catheter technique is significantly higher than standard epidural techniques because X ray guidance and direct visualization using Fiberoptic technology is utilized guaranteeing correct placement. Standard Epidural techniques have been known to fail because of incorrect placement. Failure is also due to the spread medication, which is usually to the area of least resistance to flow, that may not be the pain-generating site. Overall success is very high; sometimes it requires a series of injections and maintenance therapy.
