זריקות-אבחון-לעמוד-השדרה ד״ר תאי פריזם

Diagnostic Injections

X-rays, CT Scans and MRI’s provide excellent images of various spinal disorders. However, they cannot show pain. Spinal injections, typically used to control pain, are also used diagnostically to locate the pain source. Diagnostic spinal injections include discography (discogram), selective nerve root block (SNRB), sacroiliac joint injection and facet joint injection.

Steroid injections are a commonly prescribed treatment for numerous orthopaedic ailments, including many spinal disorders. When oral medications and/or physical therapy fail to improve a patient’s spinal condition and/or a patient has severe incapacitating pain, spinal injections can be a very effective treatment option. Depending on the type and location of the spinal problem, a small dose of steroid medicine can be injected under X-ray guidance into the right spot often alleviating the pain and inflammation immediately.

In the spine, nerve roots and intervertebral discs are the usual sources of pain. For example, a lumbar herniated disc may entrap a nearby nerve causing buttock and leg pain. The type of diagnostic spinal injection chosen is determined by the patient’s medical history, physical and neurological examination, and findings from other studies such as CT and/or MRI Scan.

Selective Nerve Root Block (SNRB)

If the nerve injected becomes numb after the procedure, and that nerve is the reason for your pain, you will feel immediately better. This helps to prove that the nerve we injected is the source of your pain. This helps in guiding future treatment options including any future surgical interventions. Under fluoroscopic guidance, Dr. Friesem injects steroid medication at a specific nerve root. The steroid is a strong anti-inflammatory. If the injection reduces or alleviates the patient’s symptoms, then the source of pain is located.

Facet and Medial Blocks

Joint inflammation between the spinal bones can cause back pain. Facet and medial blocks involve the injection of steroid medication into joint areas to determine if that joint is a pain generator. Steroids reduce inflammation and alleviate pain.

A facet joint block is an injection of local anesthetic and steroid medication into the joint. A medial block uses similar medication injected outside the joint space near the nerve that feeds that joint. These injections are performed under fluoroscopy.

If pain is relieved, it could mean that the suspect joint or medial nerve is the pain generator.

Sacroiliac Joint Injection

The sacroiliac joint is the largest joint in the spine. It is located in the lower spine above the tailbone. Inflammation of the sacroiliac joint can cause low back and buttock pain.

Using fluoroscopy, local anesthetic and steroid medication is injected into the sacroiliac joint. If pain is relieved, it could mean that the suspect joint is the pain generator.

Summary

Although not always helpful, Injections reduce pain and improve function in most people. They may provide permanent relief or provide a period of pain relief that will allow other treatments like physical therapy to be more effective.