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Injections and Procedures

The physicians at The Denver Spine and Pain Institute offer a full spectrum of interventional treatment options to help in diagnosing and treating the source of your pain. Some procedures are strictly diagnostic, some are primarily therapeutic, but all are offered to help you get back to enjoying life. All of our procedures are performed by licensed, highly skilled and experienced physicians. To ensure safety and accuracy, all of these procedures use either fluoroscopic (x-ray) or ultrasound imaging guidance.

Epidural Steroid Injections

Epidural steroid injections are utilized when you have pain coming from a spinal nerve or disc injury. They can be performed in your neck, mid-back, or lower back, depending on your symptoms. Nerve pain can result in numbness, tingling, pain and sometimes weakness. While these injections won’t correct an anatomical issue, such as remove a bone spur or shrink a disc herniation, they can significantly reduce your pain, allowing you to participate in physical therapy and learn how to prevent future flare ups from occurring.

Facet Injections/MBBs/RFA

These three procedures can be performed in your neck, mid-back, or lower back and are used for diagnosing and treating axial (non-radiating) spine pain. Facet joints are small joints between the vertebrae. They receive their nerve supply from a small nerve branch, called the medial branch. The injections are each slightly different:

Sacroiliac Joint Injections/RFA/Arthrodesis

These three procedures are designed to relieve pain if you suffer from sacroiliac (SI) joint pain.

  • Sacroiliac Joint Injections are performed by injecting either only numbing medication, or a combination of numbing medication and steroid, into the joint itself.
  • Radiofrequency ablation (RFA) is similar to the above RFA procedure for facet joint pain, but instead of targeting the medial branch nerves, it targets the lateral branch nerves that innervate the SI joint.
  • Arthrodesis is used to help stabilize and/or fuse the SI joint if all conservative therapies have failed. It is a minimally invasive procedure utilizing a small implant which contains growth factors to help the joint fuse.

Spinal Cord and Peripheral Nerve Stimulation

Spinal cord stimulation may be offered if you are experiencing neck, low back, arm, or leg pain, or CRPS symptoms, and your pain has not improved with conservative therapies. This procedure involves small electrical leads placed near your spinal cord and plugged into an implantable pulse generator. A temporary trial is first performed, and if you experience significant reduction in pain, Dr. Trainor will place permanent leads in your back.

Peripheral nerve stimulation is used to treat chronic pain coming from a nerve that is outside the brain or spinal cord. It also involves a surgical procedure to place small electrical leads next to the painful nerve to reduce or block the pain signals.

Joint, Nerve and Tendon Injections

These injections can be especially helpful in reducing pain when combined with a focused rehabilitation program.

  • Joint injections typically utilize a combination of numbing medication and steroid, which is injected into the painful joint using image guidance. Some examples include the SI joint, hip, and shoulder. These injections are used for both diagnostic and therapeutic purposes.
  • Nerve injections can be divided into injections which target nerves coming from the spinal column, and nerves outside the spinal cord. Imaging guidance is used to injection either numbing medication alone, or in combination with steroid, to diagnose the source of your pain and potentially provide longer-term relief of your symptoms.
  • Tendon injections typically involve the removal of scar tissue, followed by injection of stem cells or platelet rich plasma (PRP) to help the injured tendon heal.

Vertiflex

This device is designed to be implanted between the spinous processes in your spine, to relieve symptoms of spinal stenosis. It is minimally invasive and reversible, and performed by Dr. Trainor with fluoroscopic (x-ray) guidance at a surgery center. This procedure helps to make more room for the nerves that are affected by spinal stenosis.

Basivertebral Nerve (BVN) Ablation

BVN ablation is performed using the Intracept system to treat patients with chronic low back pain coming from the vertebral endplates. Dr. Bainbridge utilizes specialized instruments and a radiofrequency catheter to gain access to the basivertebral nerve and use heat to stop pain signals from being transmitted. This procedure is also performed using fluoroscopic guidance at an outpatient surgery center.

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Please contact us today to schedule an appointment. The Denver Spine and Pain Institute serves patients in Denver and the surrounding areas of Colorado.

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