Procedures
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Stellate Ganglion Block
What is it? A block that is performed under fluoroscopy to determine if there is damage to the sympathetic nerve chain and if it is the source of the patient?s arm pain. This is primarily a diagnostic block but it may provide pain relief in excess of the duration of the anesthetic. How is it done? A local skin anesthetic is given near the base of the neck on the affected side. A needle is inserted by ...
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Facet Joint Block
What is it? A block that is performed to confirm that a facet join is the source of pain and decrease pain and inflammation in a facet joint or joints. How is it done? The patient is given a local skin anesthetic - a needle is then inserted into the facet joint or facet capsule and an anesthetic and steroid are injected by the physician. This is done under fluoroscopy.
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Discogram
What is it? A discogram is a diagnostic test performed to view and assess the internal structure of a disc and determine if it is a source of pain. How is it done? The patient is given intravenous medication as a relaxant and pain reliever. A local anesthetic is injected into the patient's skin in the area that is being examined. A needle is inserted ...
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Facet Neurotomy
What is it? Facet neurotomy is a procedure which results in interruption of the nerve supply to a facet joint. This interruption known as denervation, is accomplished by a radio-frequency probe that heats the 2 small nerve branches to each facet joint. These nerves are called the medial branches. How is it done? With the patient in a prone position and under local anesthesia and fluoroscopic guidance, a radio-frequency needle is advanced to the base of the transverse ...
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Sympathetic Nerve Block
What is it? A block that is performed to determine if there is damage to the sympathetic nerve chain and if it is the source of pain. This is a diagnostic test primarily, but it may provide relief far in excess of the duration of the anesthetic. How is it done? A local skin anesthetic is given in the lumbar area of the back. A needle is then inserted into the back under fluoroscopy next to the vertebral ...
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Costovertebral Block
What is it? A block that is performed under fluoroscopy to identify the costovertebral joint as the pain generator and decease or relieve pain in that area and out toward the lateral rib cage. How is it done? The patient is placed in a prone position and given a local skin anesthetic. Under fluoroscopy the specific costovertebral joint(s) is identified. A needle is placed in that area(s) and an anesthetic and steroid are injected. How long does it take? Fifteen ...
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Epidural Injection
What is it? A block that is performed under fluoroscopy to confirm a specific diagnosis and/or decrease pain and inflammation. How is it done? A local skin anesthetic is given. A spinal needle is then inserted into the epidural space of the lumbar or caudal spine. An anesthetic and steroid are injected into the epidural space. Expected Results Relief of pain if the medication reaches the inflamed area or source of pain. How long does it take? Thirty minutes plus approximately forty-five ...
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Selective Nerve Root Block
What is it? A block that is performed to determine if a specific spinal nerve root is the source of pain and reduce inflammation around the nerve root thus decreasing or relieving the pain. How is it done? The patient is given a local anesthetic. The physician then locates, under fluoroscopy, a specific spinal nerve root. A needle is introduced through the skin into the area adjacent to the nerve ...
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