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Spine interventions :
Spinal pain is not always caused by disc protrusion and even disc protrusion does not always require intradiscal intervention,other problems such as inflammation of the nerve fibers or osteoarthritis of facet joints or weakness of the muscles supporting the spine(parafidus) can cause severe lumbar pain that is improved by spinal inervention. These procedures are accompanied by radiology (C-ARM) or ultrasound without surgical incision, bleeding, severe pain, and rapid recovery.
Median branch block :
Each vertebrae has four facet joints, one pair of these joints are attached to the upper vertebrae and one pair of them are attached to the lower vertebrae which lock and stable facet joints.
Many of the back pain is caused by the involvement of these joints. The nerve transmitting pain in the facet joints is only sensory. Initially the joint or its neural network is blocked with corticosteroid and local anesthetic solution and after confirmation of the diagnosis, these areas are blocked by radiofrequency, a treatment that uses radio frequency to destroy sensory nerves. When the electrode is in its proper position, radio frequency heating is used to eliminate nerve fibers that transmit pain signals. Healing with this technique can last for several years and allows the patient to accelerate the healing process with a physiotherapy and appropriate exercise program.
Lumbar epidural transfusional injections are performed to block the lumbar spinal nerve roots. The purpose of this procedure is to diagnose and treat the cause of back pain in cases where the roots of the lumbar spinal nerves may be involved. Often these techniques are used to relieve pain in the legs (sciatica) and result from pressure and stimulation of the spinal nerves due to disc protrusion, thickening of the ligament in the spinal canal, osteoarthritis (osteophytes) or listhesis.
The purpose of this technique is to relieve pressure-induced inflammation of the nerve and to modulate neural function at the nerve exit site. In this way, the necessary drugs are inserted through a special needle into the cavity(foramen) next to the vertebrae, where the nerve fibers pass through the organs and are injected into the space around the nerve. In this way, no injections into the spinal cord are performed.
Epidural block (interlaminar)
Injection into the epidural space to reduce temporary or long-term pain and inflammation is called “epidural injection”. The epidural space is the outer meningeal space. In this case, steroids, dexmedomidine, ozone and anesthetics are injected. Injecting drugs can reduce pain and swelling (inside and around) the nerve roots of the spinal cord. It also heals the tissues around the damaged nerves.
The injection is used to relieve back pain, neck, trunk and organs in the vertebral, thoracic, lumbar and sacral areas. Steroid medications can reduce swelling and inflammation caused by spinal cord diseases such as spinal canal stenosis, radiculopathy, sciatica, and disc herniation. The usual medications injected into the epidural not only relieve inflammation but also leak and dilute inflammatory mediators in the area. The choice of each of these techniques, the type of medication used, and how often it depends on the physical condition of the patient and the physician’s assessment.