X-ray Guided Pain Relieving Injections

Fluoroscopically Guided Spine injections performed by Dr. Kaplan:

• Epidural steroid injections for spine disc and nerve pain
• PRP for spine disc and nerve pain
• Lumbar, Thoracic and Cervical joint and capsule injections include steroid, PRP and Dextrose
• Sacroiliac joint and ligament injections include Steroid, Dextrose and PRP

X-ray guided injections are designed for targeted relief of pain and inflammation in several aspects of the spine and pelvis.

Disc Herniations:

Lumbar (lower back) disc herniations are a frequent source of buttock and leg pain (sciatica). As the disc material gets pushed towards the nerves that are traveling past it on the way to the legs, it causes inflammation of these nerves.

Are all epidural injections created equal?

The location of nerve irritation varies accordingly to the location of the disc material. For any injection to be effective, it needs to be directed precisely to the region of the injury. Epidural injections are commonly done through direction of the needle by feel (blind) only. It has been reported that these non-guided injections can have as much as a 60% miss rate. As a result many people that have had this type of injection mistakenly think that they would not benefit from an epidural injection in the future.

Fluoroscopic (X-ray) guided method of delivering a medication allows for the kind of precision that is not afforded by a blind technique. Under X-ray observation the needle is carefully directed next to the site of injury and the injection mixture flow is then observed to ensure that it gets to the right place. Frequently just a slight adjustment of the needle tip can make a difference between getting the medicine in the right or the wrong location.

What’s injected?
Most commonly a specially formulated steroid medication is injected. Proliferative solutions such as high concentration Dextrose (sugar) solution and PRP (platelet rich plasma) are now being injected in an attempt to regenerate the spine disc. In a recent study out of Japan by Dr Koji Akeda, intradiscal injection of Autologous Platelet-Rich-Plasma was performed for the treatment of Discogenic Low Back Pain on 12 individuals. Patients sustained a 50% reduction of pain and improvement of function for twelve months following injection. More studies are needed, but results seen by physicians performing this procedure hold great promise.

Lumbar Facet (joint) and Sacroiliac Joint Pain:

Spine and sacroiliac joint pain is typically a result of age related wear and tear, but can also be due to trauma. As the muscles and ligaments around the spine strain, the joints are exposed to stress that can cause cartilage break down and joint capsule weakness. This typically leads to painful inflammation of the joint and the joint lining.
Fluoroscopically guided injections allow accurate placement of the medication into the affected joint that is otherwise inaccessible by a blind technique.

What’s injected?
Usually a specially formulated steroid medication is injected. Proliferative solutions such as high concentration Dextrose (sugar) solution and PRP (platelet rich plasma) are now being injected in an attempt to regenerate to the joint cartilage and capsule.