Articles Posted in Medical Procedures

Spinal cord stimulation is used to manage chronic pain. Doctors implant a pulse generator that delivers an electrical pulse to the spinal cord. The electricity impairs the function of the nerve signals sent by the painful area to the pain.

Spinal cord stimulators are implanted in the back using sedation and local anesthesia. A trial run is done first using a small, temporary pulse generator. This type of percutaneous stimulator is a temporary pain-relieving device because it tends to migrate under the skin. If it works, however, a permanent spinal cord stimulator is implanted under the abdominal skin with wires passed around to the back and inserted in the spinal cord. This stimulator is considered more stable and can be used for years.

There are two facet joints at either end of a vertebral segment in the spine. In the lumbar spine, these joints help give stability to the spine and help guide its motion. Because of a back injury, arthritis or mechanical stress on the lumbar spine, there can be low back pain. One treatment of this type of pain is the lumbar facet injection. The relief of pain the person receives can help them participate in physical therapy in order to strengthen the back and keep it pain free.

Lumbar facet injections have two primary goals: the first is to help diagnose the cause and location of the low back pain and the other is to give pain relief. A facet joint injection can find the source of the pain by injecting the joint with an immediate relief anesthetic. If the pain is relieved at a particular facet joint, it is the likely source of the pain. This is especially true if complete relief is obtained.

Thoracic discography is done at a lesser rate than cervical or lumbar discography because the thoracic spine is relatively stable and disc problems are much less likely in the thoracic area when compared to the cervical area and the lumbar area. It is a test to look for disc problems in the thoracic part of the spine. There are many more problems with the thoracic spine, such as muscle pain, pain with the spine, visceral pain masking thoracic pain and facet joint pain.

The purpose of having a thoracic discogram is to see if a damaged disc is causing thoracic pain. It is similar to a lumbar and cervical discogram in that it is used to identify specific discs that are pinching on nerves causing pain in the back or in the area a peripheral nerve serves. It is done in cases of thoracic back pain or pain in the trunk and is a more successful test than an MRI or CT scan of the thoracic spine because a disc severely damaged on CT scan may not be painful while a mildly damaged disc can be the source of the pain.

An intrathecal pump is one way doctors can provide pain medication directly to the spinal cord. The pump is placed beneath the skin of the abdomen and is programmed to deliver a specific amount of pain drug to the spinal cord. The pump itself is attached to a catheter similar to the one used on women during childbirth.

The catheter goes into the back and is inserted into the intrathecal space around the spinal cord itself. Because the spinal cord is given the medicine directly, there are fewer generalized symptoms and less medication needs to be given. One needs only about 1/300 of the medication necessary when given by intravenous means.

The cervical facet joints are important for cervical spinal stability and for providing motion of the neck. Unfortunately, they can easily become injured or arthritic, leading to localized joint pain or pain along the spinal nerve that exits the lateral spinal canals. This kind of pain leads to radicular pain, which can be on the arms or upper chest.

When the facet joint becomes injured or arthritic, the choices of pain relief might include surgical fusion, pain medication and facet joint infection. The advantages of facet joint injection include short recovery time after the procedure and the lack of addiction potential, as would be seen with some pain medications.

Cervical pain rivals low back pain as the number one type of spinal pain injured people can have. It is a particularly annoying pain as it can lead to headaches, neck pain and pain along the exit route’s travel, which, in the case of the neck, is usually in the upper arms.

Cervical pain can be caused by many things. In most cases, it is the result of musculoskeletal pain or ligamentous pain in the cervical area. In some cases, there can be damage to the disc so that pressure is put on the spinal nerves, leading to referred pain to the neck, shoulders or arms. The discs are soft, cushiony pads that separate the hard vertebrae of the spine. The disc can bulge into the spinal canal, pushing on the spinal cord, leading to distal pain. It can also tear or degenerate causing localized cervical pain.