Nonsurgical Spinal Procedures

It is fairly common for patients to undergo diagnostic and/or therapeutic spinal injections for acute or chronic spine and extremity pain. At times these procedures are performed to help prevent further surgical interventions. At other times, the procedures are performed to help correctly diagnose the levels in the spine to be treated.

These procedures typically include selective nerve blocks, also known as transforaminal epidural steroid injections, and diagnostic facet injections. Epidural injections can be performed 3 to 4 times a year if they produce long-term pain relief.

The facet joints are stabilizing structures found throughout the cervical, thoracic and lumbar spine. Medial branch nerve blocks are performed to isolate the painful joint or joints. Depending on the results of these injections and or blocks, further treatment plans will be developed.

Radio Frequency Ablation

Radio frequency ablation or RFA is a procedure for chronic low back and neck pain due to arthritic joints in the back. Once the painful joints in the cervical, thoracic or lumbar spine are identified, radiofrequency energy can be used to ablate the nerves to those joints. This procedure typically provides pain relief for approximately 9 to 14 months. It can be repeated on a yearly basis as needed.

The Intracept Procedure, which was recently approved by the FDA to treat Chronic Low Back Pain, also uses radiofrequency energy to ablate painful nerves in the spine. (drop down info?) In this procedure, the targeted nerves, the Basivertebral Nerves, lie within the vertebral bodies of the spine.  Unlike treating facet joint nerves on a yearly basis, one treatment using the Intracept Procedure is providing greater than 5 years of pain relief for patients. Both Drs Sloan and Seigel are highly trained in these procedures, and in determining who might be a good candidate.

Image Guided Injections

All diagnostic and therapeutic injections are done using some type of image guidance. In the spine, imaging is typically performed using live x-ray provided by a fluoroscope. When injecting joints and other soft tissue structures (tendons, ligaments) ultrasound is often utilized.

Drs. Brian Seigel and Tyson Sloan provide Guided Epidural Steroid Injections.

EMG Testing

Electromyography (EMG) studies are used to assess nerve health or to detect different muscle conditions. Most commonly an EMG is prescribed to check for pinched nerves either in the spine or in the arm such as carpal tunnel.

An EMG test is two tests in one. The first part of the test uses a machine that that sends a small shock to the nerve, and the response is recorded. Based on the response of the nerve, the physician can tell many different things about the health of the nerve. The second part of the test includes a very thin needle that is placed in specific muscles and the nerve signals are both visually observed and listened to generate a diagnosis.

Dr. Tyson Sloan has performed EMG tests for over 14 years and is highly skilled at reading the results and implementing detailed care plans for his patients, based on the test.