Spinal infiltration (transforaminal)

Spinal infiltration (transforaminal) with long-lasting steroid is a minimally invasive method that introduces a local anesthetic and a very strong steroid on the inflamed nerve.

The nerves that control the arms and legs come out of the spine through small lateral openings. These nerves become compressed, irritated and inflamed by intervertebral discs that are herniated or by bone deposits - those "beaks" that are visible even in simple RX examinations.

It is performed in case of pain due to irritation caused by disc hernias, disc protrusion, vertebral stenosis.

What you should expect:

After an initial tomography which shows the precise place where the infiltration will be made, the skin is sterilized and anesthetized locally. Then, the needle is advanced to the selected level under repeated X-ray control and the mixture of local anesthetic and steroid is injected.

The procedure generally lasts just a few minutes, and the pain of this procedure is similar to an regular intra muscular injection.

It is expected that the pain will start to decrease within 3-5 days and will disappear completely in about 14 days after the procedure. The pain should be gone for a period which can vary from weeks to months and sometimes to years, depending on the each patient’s body reaction.

The patient will stay for 10-15 minutes after the procedure in the clinic for observation and then he can go home. It is not recommended for the patient to drive the car after infiltration.

Depending on the therapeutic response, it may be advisable to repeat the infiltration two or three times within two weeks. This therapy can be repeated three to four times a year.

Infiltration

Infiltrations can also be done:

  • intraarticular- in chronic pain of osteoarthritsis, coxarthrosis (hyaluronic acid, PRP, stem cells from fat - the Lipogems method - can also be injected) in the sacroiliac joints;
  • in chronic pain of the muscle tendons (tendinitis);
  • in chronic pain of the peripheral nerves (carpal tunnel syndrome, ulnar neuropathy, etc.)

Radiofrequency ablation

Radiofrequency ablation is a minimal invasive procedure that uses radio waves or electric current to generate heat in the nerve, thus blocking the transmission of the painful nerve signal. Through this procedure the nerves remain "blocked" (inactive) between 3 and18 months. The procedure can then be repeated. It is indicated for patients with severe pain in the cervical spine, lumbar spine that has not responded to conservative treatments, severe trigeminal neuralgia resistance to treatment.

Duration of procedure: between 20-60 minutes

Disc -FX

Disc-FX is a minimal invasive procedure that addresses discolored disc herniation (with a moderate degree of disc degeneration where the disc is not broken) that did not respond to conservative therapy (kinetotherapy, infiltration with steroids).

It is performed with minimal skin incision, with local anesthesia and light anesthesia on the vein, under radiological guidance in order to place the Disc-FX system precisely on the disc.

After the device is placed in the center of the disc, the damaged tissue (pulp nucleus) is removed, thus decreasing the pressure that the disc exerts on the spinal nerve, thus considerably reducing the symptoms.

In addition to classical nucleoplasty, the procedure also causes electrothermal repair of the disc. Duration of the procedure: 1-2 hours. After the procedure, the patient does not need hospitalization and will leave home. Contraindications: vertebral fractures, massive disc hernias, severely degenerated discs.

Advantages:

  • The patient is not subject to the major risk of classical open surgery,
  • The procedure does not require admission into the hospital,
  • The patient can continue his / her daily activities and can quickly start recovering physically
  • The procedure can be performed on several levels of the spine during the same session.

Endoscopic discectomy

Endoscopic discectomy is a minimally invasive procedure that removes symptomatic broken hernias or hernias to which nucleoplasty is contraindicated. By removing the hernia, the spinal nerve is decompressed, thus eliminating the pain caused by the inflammation.

It is performed with the patient being minimally sedated on the vein and with the local anesthetic. A minimal incision in the skin is performed through a cannula through which an endoscope is then inserted with which the hernia is removed.

Duration: 1-2 hours

Advantages to classic surgery:

  • minimal bleeding,
  • no muscle or bone destruction,
  • no scars or post-intervention fibrosis,
  • no later instability,
  • rapid recovery,
  • no need for admission into the hospital.

Epiduroscopy

Epiduroscopy - the minimally invasive procedure that can be performed both for diagnostic and for therapeutic purposes at the same time.

Using this procedure allows for the exploration of the epidural space through a catheter, attached to a video camera (epidural), inserted through local anesthesia at the coccyx, to identify possible scars, adhesions, fibroses around the nerves.

Once identified, these adherents / fibroses can be removed and a steady-acting steroid can be injected for therapeutic purposes, which will now have a better penetration, thus a greater effect on pain.

This procedure is recommended in chronic lumbar pain with or without irradiation on the member, which occurs after failed disc hernia operations and vertebral stenosis.

Peripheral nerve blocks

Peripheral nerve blocks mean injecting anesthetic into the plexus nerve or lymph nerve responsible for transmitting pain to an organ or a region of the body. Blocks have several purposes:

  • diagnosis (inject a minimum amount of anesthetic with short duration of action to identify the precise source of pain)
  • Indications: Diagnosis of pain in cervical, lumbar arthritis, pelvic pain

  • therapeutic (nerve blockage in order to eliminate acute pain)
  • Indications: trigeminal neuralgia resistant to treatment, chronic migraine, continuous hemicrania

Osteocool (palliative treatment of spinal metastases)

Osteocool (palliative treatment of spinal metastases) is a minimally invasive technique based on the principle of the radiofrequency wave with thermal effect. Ablation of the tumor is done with high precision with the preservation of adjacent structures. During the same procedure, which takes less than 1 hour, the thermal ablation of the secondary tumor is being done as well as the vertebroplasty if needed.

It is recommended for secondary tumors under 30 mm.

The only contraindication is for patients with pacemaker due to radiofrequency waves.

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