The following are types of spine and pain management procedures that IMI performs:
Myelogram : A Myelogram is a simple test performed to look at the spinal sac and the nerve roots that exit from the spinal canal. There are two types of Myelograms; Low Dose Myelogram and Full Dose Myelogram. In both cases, the radiologist will place contrast (x-ray dye) into the spinal sac, through a small needle that he/she inserts into the lower back. When the contrast material is injected into the subarachnoid space, the radiologist is able to view and evaluate the status of the spinal cord, the nerve roots and the meninges. The meninges are the membranes which surround and cover the spinal cord and nerve roots. Myelography provides a very detailed picture of the spinal cord, nerve roots, subarachnoid space and spinal column. The radiologist views the passage of contrast material in real-time within the subarachnoid space as it is flowing using fluoroscopy but also may take permanent images, called x-rays or radiographs, of the contrast material around the spinal cord and nerve roots in order to document abnormalities involving or affecting these structures. In most cases, the myelogram is followed by a computed tomography (CT) scan to better define the anatomy and any abnormalities.
Nerve block: A nerve block is an anesthetic or anti-inflammatory injection targeted toward a certain nerve or group of nerves to treat pain. The purpose of the injection is to "turn off" a pain signal coming from a specific location in the body or to decrease inflammation in that area. Imaging guidance, such as fluoroscopy or computed tomography (CT scan), may be used to help the doctor place the needle in exactly the right location so that the patient can receive maximum benefit from the injection. People who suffer from either acute or chronic pain might have a nerve block to achieve temporary pain relief. Often, such pain originates from the spine, but other areas commonly affected include the neck, buttocks, legs and arms. Performing a nerve block allows a damaged nerve time to heal or relieve a state of irritation. Additionally, nerve blocks can provide diagnostic information to the doctor. By performing a nerve block and then monitoring how the patient responds to the injection, the doctor can often use this information to help determine the cause or source of the pain.
Epidural: An epidural injection is a block that is performed with imaging guidance in order to confirm a specific diagnosis and/or decrease pain and inflammation. A needle is inserted into the epidural space of the spine, then a steroid and/or anesthetic are injected into the epidural space. Relief of pain occurs when the medication reaches the inflamed area or source of pain.
Vertebroplasty: A vertebroplasty is an image-guided, minimally-invasive, nonsurgical therapy used to treat a broken vertebra (spinal bone) that has been weakened by osteoporosis or, less commonly, cancer. Vertebroplasty can decrease pain, increase the patient’s functional ability, allow a return to the previous level of activity, and prevent further vertebral collapse. It is usually successful at alleviating the pain caused by a compression fracture. Often performed on an outpatient basis, vertebroplasty is accomplished by injecting “bone cement” through a needle into the fractured bone.
Lumbar Puncture: A lumbar puncture (also called a spinal tap) is a minimally invasive, image-guided diagnostic test that involves the removal of a small amount of cerebrospinal fluid—the fluid that surrounds the brain and spinal cord—or an injection of medication or other substance into the lumbar (or lower) region of the spinal column.
Blood Patch: Blood patches are performed for treatment of a persistent headache (spinal headache) and nausea that sometimes follows a spinal puncture. These symptoms do not occur frequently. The blood patch procedure consists of an injection at the spinal tap site of a small quantity of autologous blood. The introduction of this blood acts to patch the hole in the dura (the outer membrane of the spinal cord) that was created by the needle at the time of the procedure. This results in pain relief for most patients.
Facet Joint injection: Facet joints are small joints at each segment of the spine that provide stability and help guide motion. The facet joints can become painful due to arthritis of the spine, a back injury or mechanical stress to the back. As with many spinal injections, facet joint injections are best performed using imaging for guidance to properly target and place the needle and to help avoid nerve injury. A small area of skin on the back will be numbed with anesthetic. The physician will then use imaging guidance to direct a very small needle into the appropriate position. Several drops of contrast dye are injected to confirm needle tip position.. A mixture of anesthetic and anti-inflammatory medication is then slowly injected.