Spine Treatment & Pain Management
- Joint Steroid Injections
- Facet Blocks
- Epidural steroid injection (ESI)/ SI joint injection
Over 700,000 new cases of vertebral compression fractures (VCF) occur each year, typically affecting elderly men and women with osteoporosis. Younger patient may also suffer from VCF due to fragile bones from chronic steroid use. For many elderly, VCF typically means debilitating constant pain, reduced mobility, narcotic pharmacotherapy, and reduced quality of life. Although surgical options exist, spinal surgery is invasive, difficult and risky and therefore is not typically applicable, except as a last option.
Vertebroplasty is a relatively new treatment available for painful compression fractures. Using fluoroscopic guidance, an AVIC specialist delivers a bone cement mixture into the broken vertebra percutaneously without a surgical incision. Vertebroplasty is an outpatient procedure and often performed under 1 hour. Typically, pain is resolved within few days, allowing patients to return to daily activities. Sometimes the pain relief is immediate.
Kyphoplasty is very similar to vertebroplasty. The only difference is that prior to delivering the cement in the bone, the interventional radiologist will inflate a balloon inside the broken vertebra to create a â€œpocketâ€ for the cement and decrease the chances of cement leaking out.
What are Steroid Injections?
Oral medicines can serve to temporarily decrease inflammation, but may not be strong enough to halt the vicious cycle of pain. Direct administration of steroids into the joint at the site of inflammation can help put the brakes on the inflammation, allowing you to rehabilitate the joint. Therefore, getting the inflammation under control is the key to recovery.
What Happens During the Steroid Injections?
With x-ray guidance, almost any joint in the body can be targeted for steroid injection. Our experts at AVIC use a small needle for your steroid injections. You may experience a small sensation of pain as the needle is inserted. Your physician may recommend that you repeat your steroid injections for best results.
What Happens After the Steroid Injections?
Once the pain is at a tolerable level, physical therapy can be more effective in allowing you to break up the scar tissue, and return to normal use of the joint.
The facet injection targets the facet joints that connect the bones of the spine at each level
What is a Facet Injection?
The facets are the joints connecting the bones of the spine at each level. Like any other joint in the body, these facet joints undergo normal wear and tear and can become inflamed. One way to treat this inflammation, for a much longer period than just oral medications, is to inject a steroid into the facet. The steroid treats the inflammation for weeks to months, and can help patients to stop using oral medicines.
What Happens During the Facet Injection?
Under x-ray guidance, an anti-inflammatory steroid and local anesthesia are injected into the affected facet joints. You can repeat your facet injection several times per year, as recommended by your physician.
What Happens After the Facet Injection?
In most cases, patients experience a significant improvement in their discomfort. Some patients do not experience pain relief for up to one week after their facet injection. You may be required to have someone drive you home after the procedure. Your physician may advise you to avoid your normal activities for one day after your facet injection.
An ESI is a minimally invasive procedure that can help relieve back and leg pain caused by inflamed spinal nerves. A steroid and an anesthetic numbing medicine are injected into the epidural space, directly into the painful area. Epidural steroid injections may be performed to relieve pain caused by spinal stenosis, spondylolysis, and disc herniation. The pain relief can last from days to years. The goal is to reduce the pain so that the patient can resume normal activities and a physical therapy program.