OrthoNeuroSpine & Pain Institute

Lumbar Procedures

Procedures for chronic low back pain

Lumbar Facet Injection

A lumbar facet injection is an outpatient procedure for low back, buttock, hip, and groin pain. Facet joints are located on both sides of your spine to connect the vertebrae. The joints help guide your spine when you move. Facet joint pain can feel like mild muscle pain to severe incapacitating pain.

At times, the cartilage inside the joint may be injured. Other times, only connecting ligaments surrounding the joint are injured. In this procedure, an anti-inflammatory corticosteroid is injected into one or more of your lumbar facet joints. Your doctor can use your results to diagnose or treat your pain.

Lumbar Medial Branch Block

Medial branches are small nerves feeding out from the spine’s facet joints. A lumbar medial branch block is an outpatient procedure used to diagnose facet-related low back, buttock, hip, and groin pain.

Medial branch nerves are located near facet joints and transmit pain signals from the facet joints to your brain. Facet joints are located on both sides of your spine to connect the vertebrae. The joints help guide your spine when you move.

In this procedure, an anesthetic is injected near the medial branch nerve to stop pain signals from transmitted from the facet joint. If this reduces your pain and increases normal movement, it helps your doctor diagnose and treat the facet joint is causing your pain.

Lumbar Radiofrequency Ablation (RFA)

RFA is an outpatient procedure for low back, buttock, hip, and groin pain. RFA uses radiofrequency energy to disrupt nerve function, such as transmitting pain from an injured facet joint.

In this procedure, radiofrequency energy is focused on a specific medial branch nerve(s) to stop signaling. Medial branches are small nerves feeding out from the spine’s facet joints. RFA is also known as lumbar facet thermal coagulation or rhizotomy.

If this reduces your pain and increases normal movement, it helps your doctor diagnose and treat the facet joints causing your pain.

In general, Radiofrequency Ablation results last longer than steroid treatments for facet pain.

Procedures for low back and leg pain

Lumbar Caudal Epidural Steroid Injection

A lumbar caudal epidural steroid injection is an outpatient procedure for treating low back and leg pain. The epidural space is the space surrounding the dural sac – a protective covering of the spinal cord, spinal fluid, and its nerves. If you have pain in your low back when you bend your back, you may have lumbar disc or dural inflammation. If pain travels to your leg when you move your back, you may have nerve root irritation and/or inflammation.

In a lumbar epidural injection, an anti-inflammatory corticosteroid is injected into the epidural space to reduce inflammation. When the injection is performed via the bony opening in your tailbone this is called a caudal epidural injection.

Lumbar Interlaminar Epidural Steroid Injection

A lumbar interlaminar epidural steroid injection is an outpatient procedure for treating low back and leg pain. The epidural space is the space surrounding the dural sac – a protective covering of the spinal cord, spinal fluid, and its nerves.

If you have pain in your low back when you bend your back, you may have lumbar disc or dural inflammation. If pain travels to your leg when you move your back, you may have nerve root irritation and/or inflammation.

In a lumbar epidural injection, an anti-inflammatory corticosteroid is injected into the epidural space to reduce inflammation. When the injection is performed from the back of the spine, it is called an interlaminar injection.

Lumbar Selective Nerve Root Block

A lumbar selective nerve root block is an outpatient procedure for treating low back and leg pain. The epidural space is the space surrounding the dural sac – a protective covering of the spinal cord, spinal fluid, and its nerves.

If you have pain in your low back when you bend your back, you may have lumbar disc or dural inflammation. If pain travels to your leg when you move your back, you may have nerve root inflammation.

In this procedure, an anti-inflammatory corticosteroid is injected in the epidural space to reduce inflammation. When the injection is performed adjacent to an individual nerve root, it is called a selective nerve root block. This places medication directly along the targeted, inflamed nerve root, and can determine if a specific nerve is causing your pain.

Lumbar Transforaminal Epidural Steroid

A lumbar transforaminal epidural steroid injection is an outpatient procedure for treating low back and leg pain. The epidural space is the space surrounding the dural sac – a protective covering of the spinal cord, spinal fluid, and its nerves.

If you have pain in your low back when you bend your back, you may have lumbar disc or dural inflammation. If pain travels to your leg when you move your back, you may have nerve root inflammation.

In a transforaminal epidural injection, an anti-inflammatory corticosteroid is injected into the epidural space to reduce inflammation. When the injection is made from the side where the nerve exits the spine, it is called a transforaminal injection. This technique puts the medication near the source of inflammation.

Cervical Procedures

Procedures for chronic neck pain and headache

Cervical Medial Branch Block

A cervical medial branch block is an outpatient procedure for diagnosing and treating neck, shoulder upper back and headache pain. Medial branches are small nerves feeding out of the spine.

These nerves are located near facet joints and transmit pain signals from the facet joints to your brain. Facet joints are located on both sides of your spine to connect the vertebrae. When cervical facet joints are injured, you can feel muscle tension to severe pain from your head down to your lower shoulder blade.

In this procedure, we inject anesthetic near the medial branch nerve to stop pain signals from transmitting from the facet joint. If this reduces your pain and increases normal movement, it helps your doctor diagnose and treat the facet causing your pain.

Cervical Radiofrequency Ablation (RFA)

A cervical radiofrequency ablation (RFA) is an outpatient procedure for treating neck, shoulder, and upper back pain. RFA uses radiofrequency energy to disrupt nerve function, such as transmitting pain from an injured facet joint.

In this procedure, radiofrequency energy is focused on a specific medial branch nerve(s) to stop signaling. RFA is also known as cervical facet thermal coagulation or rhizotomy.

If this reduces your pain and increases normal movement, it helps your doctor diagnose and treat the facet causing the pain.

Procedures for neck and arm pain Cervical Interlaminar Epidural Steroid Injection

A cervical interlaminar epidural steroid injection is an outpatient procedure for treating neck, upper back, shoulder, and arm pain. The epidural space is the space surrounding the dural sac – a protective covering of the spinal cord, spinal fluid, and its nerves. In the neck, it is called the cervical epidural space.

If you have pain in your neck or upper back when you move your head or neck, you may have cervical disc and dural inflammation. If pain travels to your arm when you move your head or neck, you may have nerve root inflammation.

In a cervical epidural steroid injection, an anti-inflammatory corticosteroid is injected into the cervical epidural space to reduce inflammation. When the injection is made from the back of the spine, it is an interlaminar injection.

Cervical Transforaminal Epidural Steroid Injection

A cervical transforaminal epidural steroid injection is an outpatient procedure for treating neck, upper back, shoulder, and arm pain. The epidural space is the space surrounding the dural sac – a protective covering of the spinal cord, spinal fluid, and its nerves. In the neck, it is called the cervical epidural space.

If you have pain in your neck or upper back when you move your head or neck, you may have cervical disc and dural inflammation. If pain travels to your arm when you move your head or neck, you may have nerve root inflammation.

In a cervical transforaminal epidural injection, an anti-inflammatory corticosteroid is injected into the epidural space to reduce inflammation. When the injection is made from the side where the nerve exits the spine, it is called a transforaminal injection. This technique puts the medication near the source of inflammation.

Cervical Selective Nerve Root Block

A cervical selective nerve root block is an outpatient procedure for diagnosing and treating neck, upper back, shoulder, and arm pain. The epidural space is the space surrounding the dural sac – a protective covering of the spinal cord, spinal fluid, and its nerves. In the neck, it is called the cervical epidural space.

If you have pain in your neck or upper back when you move your head or neck, you may have cervical disc and dural inflammation. If pain travels to your arm when you move your head or neck, you may have nerve root inflammation.

In this procedure, an anti-inflammatory corticosteroid is injected in the epidural space to reduce inflammation. When the injection is done next to an individual nerve root, it’s called a nerve root block. This places medication directly along the targeted, inflamed nerve root, and can determine if a specific nerve is causing your pain.