Interventional Spine Procedures

Here at NWMR, we pride ourselves in not only properly diagnosing your condition, but also treating it in the most conservative way possible. Fluoroscopic (x-ray guided) spinal injections can be a safe and effective tool to diagnose and treat persistent pain whether it stems from arthritis, inflammation or nerve irritation.

During fluoroscopy, the patient is positioned between an x-ray source and a fluorescent screen. The live images generated by the fluoroscope allow the physician to visualize and target the suspected physical generators of pain within the body. The radiation exposure from fluoroscopy is minimal and the real-time imaging allows for precision, comfort and safety during interventional pain procedures.

Benefits of fluoroscopic injections include:

• Precise and safer localization of pain-generating structures
• Guiding and documenting placement of medication even in patients with difficult anatomy
• Predicting the results of proposed surgical intervention
• Guiding surgical therapy

Medications used alone or in combination include steroids and local anesthetics. Once these medications are delivered to their target, they may block pain impulses, stabilize irritated nerve structures, reduce inflammation and swelling, and reverse the biochemical changes that are known to occur within the nervous system when pain persists.

Disc herniation, degeneration and secondary spinal inflammation do not usually cause nerve damage, thus early surgical intervention is often not indicated. Since a herniated disc material may be reabsorbed over time by the body without surgery and since surgery cannot “cure” the underlying problem of disc degeneration, it is usually wise to consider surgical intervention only after conservative care fails.

Spinal injections are considered an extension of conservative care by many spine specialists. Generally it is agreed upon by experts doing these procedures that you receive no more than 3 of the same type of injection in the same region in a 12 month period. For this reason, we at NWMR, as well as many other specialists in the nation, do not automatically perform the “series of three” injections. There is no evidence that this provides any additional benefit, especially if you obtain relief after a single injection. This way, should the relief wear off, you still have two more injections in your back pocket to save you down the road.

In his residency training, Dr. Soto was extensively trained by both Anesthesiologists and Physiatrists in these procedures and has safely performed hundreds of these injections. For more information on the different types of spinal injections, please see our Pain management education section. If you have been scheduled for an intervention, please see our Surgery Instructions section for things you need to know before your procedure.