North State Interventional Radiology

An epidural injection is one of many methods doctors use to relieve pain, along with physical therapy, nerve blocks, oral medications and surgery. An epidural injection may be performed to alleviate pain caused by:

• A herniated or bulging disk
• Spinal stenosis
• Other injuries to spinal nerves, vertebrae and surrounding tissues

The injection is delivered into the epidural space of the spine to provide temporary or prolonged relief from pain or inflammation. Steroids, anesthetics and anti-inflammatory medications are typically delievered in an epidural injection. The injection may reduce pain and swelling in and around the spinal nerve roots, as well as around damaged nerves which in time may heal. Our interventional radiologist utilizes image guidance by fluoroscopy or computed tomography (CT or “CAT” scan) to help target the exact location of pain so the patient can recieve the maximum benefit from the injection. Click here for an informational video on Epidural Steroid Injections.

Lumbar facet joints are small joints located in pairs in your lower back. They help guide motion and provide stability. Facet joint pain can result from arthritis, injury, or mechanical stress, and cause pain in various areas in your lower back, hip, buttock, or leg.

A facet joint injection serves dual purposes. First, by placing numbing medicine into the joint, the amount of immediate pain relief you experience will help confirm or deny the joint as a source of your pain. That is, if you obtain complete relief of your main pain while the facet joints are numb, then these joints are likely your pain source. Furthermore, time-release cortisone will be injected into these joints to reduce any presumed inflammation, which can, on many occasions, provide long-term pain relief. Click here for an informational video on Facet Joint Injections.

Facet Joints are innervated or “supplied” by nerves called “medial branches”. These nerves carry the pain signals to the spinal cord and the signals eventually reach the brain, where the pain is noticed. The medial branch block can prevent the conduction of pain information for several weeks to months. Click here for an informational video on Medial Branch Block procedures.

Radiofrequency Ablation is a pain management procedure used to interrupt nerve conduction on a semi-permanent basis. Using a specialized machine, the procedure disrupts nerve conduction (such as conduction of pain signals), and may in turn reduce pain, and other related symptoms. The nerves are usually blocked for 6-9 months (but can be as short as 3 months or as long at 18 months). Approximately 70-80% of patients will get good block of the intended nerve. This should help relieve that part of the pain that the blocked nerve controls. Sometimes after a nerve is blocked, it becomes clear that there is pain from the other areas as well.

Sacroiliac Joint Injection is an injection of long lasting steroid (“cortisone”) into the Sacroiliac joints – which are located in the low back area. The injection consists of a mixture of local anesthetic (like lidocaine or bupivacaine) and the steroid medication (triamcinolone – Aristocort® or methylprednisolone – Depo-medrol®). The actual injection takes only a few minutes. The steroid injected reduces the inflammation and/or swelling of tissue in the joint space. This may in turn reduce pain, and other symptoms caused by inflammation / irritation of the joint and surrounding structures.  Click here for an informational video on Sacroiliac Joint Injections.

Arthritis
Arthritis literally means inflammation of one or more joints. A joint isan area of the body where two different bones meet.

Anesthetic
A substance that causes lack of feeling or awareness. A local anesthetic causes loss of feeling in a part of the body. A general anesthetic puts the person to sleep.

Computed Tomography
An x-ray procedure that uses the help of a computer to produce a detailed picture of a cross section of the body. Also called a CT scan or CAT scan.

Fluoroscopy:
An x-ray procedure that makes it possible to see internal organs in motion. Fluoroscopy uses x-ray to produce real-time video images. After the x-rays pass through the patient, instead of using film, they are captured by a device called an image intensifier and converted into light. The light is then captured by a TV camera and displayed on a video monitor.

Herniated disc:
Rupturing of the soft, springy tissue that separates the vertebral bones of the spinal column.

Intradiscal Electrothermal
The use of heat to modify the nerve fibers of a spinal disc by way of passing an electrical current through a catheter.

Spinal Stenosis:
Narrowing of the spaces in the spine, resulting in compression of the nerve roots or spinal cord by bony spurs or soft tissues, such as disks, in the spinal canal.

Steroid:
A general class of chemical substances that are structurally related to one another and share the same chemical skeleton.

Varicose vein:
A dilated (widened) tortuous (twisting) vein, usually involving a superficial vein in the leg, often associated with incompetency of the valves in the vein. These visible and bulging veins are often associated with symptoms such as tired, heavy, or aching limbs. In severe cases, varicose veins can rupture, or open sores (varicose ulcers) can form on the skin.

Venous Access:
Access through a vein to perform a medical procedure.