Surgeries and Procedures

In a microdiscectomy or a microdecompression, a small portion of the bone over the nerve root and some of the disc material from under the nerve root is removed to relieve pressure on the nerve and provide room for the nerve to heal.A microdiscectomy is typically performed for lumbar herniated disc and is more effective in relieving symptoms of leg pain than for low back pain.

An epidural steroid injection is a minimally invasive procedure that delivers steroids via a needle directly into the epidural space to help reduce inflammation. The injection may consist of steroids that inhibit the production of painful inflammatory substances and/or a lidocaine or saline solution to help flush out inflammatory proteins from around the affected area. Epidural steroid injections are typically administered to patients with chronic pain due to lumbar disc herniation, degenerative disc disease and lumbar spinal stenosis. The analgesic effect is temporary, but can be an effective nonsurgical treatment.

Another common injection, a selective nerve root block (SNRB), is primarily used to diagnose the specific source of nerve root pain and, secondarily, for therapeutic relief of low back pain and/or leg pain.When a nerve root becomes compressed and inflamed, it can produce back and/or leg pain. Occasionally, an imaging study (e.g. MRI) may not clearly show which nerve is causing the pain and an SNRB injection is performed to assist in isolating the source of pain. In addition to its diagnostic function, this type of injection for pain management can also be used as a treatment for a far lateral disc herniation (a disc that ruptures outside the spinal canal).

Epiduroscopy, also known as epidural spinal endoscopy or epidural myeloscopy, is an endoscopic procedure in which the epidural space is explored for the purpose of diagnosing and treating spinal pain, specifically radicular pain. A steerable or controllable flexible endoscope is used to examine the epidural anatomic structures to find epidural adhesions, fibrosis and scars, and to provide precision directed therapy. .

Medial branch nerves are small nerves that feed out from the facet joints in the spine and carry pain signals from the facet joints to the brain.The procedure is primarily diagnostic, meaning that if the patient has the appropriate duration of pain relief after the medial branch nerve block, then he or she may be a candidate for a subsequent procedure - called a medial branch radiofrequency neurotomy (or ablation) - for longer term pain relief.
A trigger point injection is an outpatient procedure designed to reduce or relieve the back pain caused by trigger points, which are small knots that form in muscles or in the fascia tissue leading to pain caused by muscle irritation (myofascial pain).

Posterolateral gutter fusion surgery is the gold standard surgical approach to achieve spinal fusion. This surgical approach involves placing bone graft in the posterolateral portion of the spine (area just outside the spine). An incision is made at the midline of the back and bone graft is placed underneath the large back muscles that attach to the transverse processes of the affected vertebrae. The posterolateral vascular area is important to the fusion since it carries blood and nutrients to the site of fusion

Conditions Treated:

  • Back and Neck Injuries
  • Herniated Discs
  • Spinal Cord Injuries
  • Spinal Stenosis
  • Soft Tissue Injuries
  • Degenerative Discs