Spinal interventions under fluoroscopic guidance

Some physiatrists specialize in spinal interventions, performing procedures under fluoroscopic guidance. These interventions utilize fluoroscopy, a form of real-time X-ray imaging, to treat various spinal issues.

Types of Problems Treated

Our therapists treat a variety of issues using fluoroscopic-guided interventions, such as:

• Headaches
• Neck pain
• Back pain
• Sciatica or brachialgia (leg or arm pain originating from the spine)

How It Works

1. Consultation with our experienced spinal intervention team: You will be met by a medical imaging technologist and a nurse.
2. Assessment of your problem: The physiatrist will ask questions and conduct an examination during your consultation.
3. Proposal of a treatment plan: The physiatrist will propose a treatment plan, which may include medication or non-medicated options. A spinal procedure might be offered and performed on the same day. Use of Fluoroscopy: Fluoroscopy uses low-intensity X-rays to visualize bones and joints in real-time, allowing for precise and safe injections around the spine.

General Contraindications

• Pregnancy: Fluoroscopy involves radiation, albeit at very low levels, and is therefore contraindicated during pregnancy.

Corticosteroid Injections

Interventions spinales offertes:

• Facet joint injections
• Sacroiliac joint injections
• Transforaminal epidural injections
  Caudal epidural injections

For more information about cortisone injections, please refer to the dedicated section on our website.

Medial Branch Blocks and Radiofrequency Ablation of the Medial Branches (Thermolesion)

What Are Cortisone Injections?

Thermal lesioning is a treatment that involves burning the nerves responsible for sensation in the facet joints of your back or neck. It is used exclusively to treat pain originating from facet joints that are resistant to standard treatments. This procedure offers the possibility of longer-lasting relief, although it is not permanent.
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Steps of the Procedure

1. Initial assessment: The physiatrist will ask questions, conduct an examination, and review previous consultations and treatments to determine the source of the pain.
2. Heat injury eligibility:
   1. The physiatrist will perform tests called medial branch blocks by injecting an anesthetic around the nerves.
   2. Test confirmation: The test is repeated at a second appointment to confirm eligibility for thermolysin.
3. Radiofrequency Ablation: If the tests are conclusive, the physiatrist will perform radiofrequency ablation of the nerve branch to block the pain signal.

What to Expect from the Procedure

• Mild pain: The procedure may cause slightly more discomfort than a standard injection.
• No General Anesthesia: The procedure is performed while the patient is awake to minimize risks.
• Local anesthetic is used before radiofrequency ablation.
• Post-procedure pain: Commonly, pain may worsen for up to two weeks following the procedure. Relief can be achieved with ice and Tylenol.
• Duration of effect: Typically lasts between 12 and 18 months, sometimes longer. The procedure can be repeated if necessary and remains effective.

Recommendations

Before the Injection

• Accompanying person: Please arrange for someone to accompany you after the procedure.
• Jewelry: Please remove necklaces and earrings before the procedure.

After the Injection:

• Please refer to the dedicated section on our website for post-injection recommendations.