Spine Health Services at the Norman Prince Spine Institute
The Norman Prince Spine Institute’s systematic approach begins from the moment a patient walks through our doors, with every member of our care team working toward the goal of long term pain management and improvement in each patient’s function and quality of life. Our comprehensive care model includes consultation and evaluation; medical, surgical, and minimally invasive treatment options; and support services to aid in rehabilitation.
When you combine the skills and determination of a brain surgeon committed to medical progress, like Oyelese Adetokunbo, MD, with the precision technology of the Globus Excelsius robot, you get the most advanced care anywhere. Learn how we treat spinal disorders using this technology.
Spine Health Treatment Options
Medical and Interventional Treatments and Procedures
Based on the initial evaluation and review of diagnostic imaging, patients will typically begin their care with medical or interventional treatments and procedures. These conservative approaches are combined with fluoroscopy (x-ray) or ultrasound technology, and are often accompanied by techniques such as physical or occupational therapy.
BOTOX for migraine heachaches
BOTOX, a prescription medicine, can be injected into specific points, such as the forehead, temples, or back of the head or neck, to prevent headaches in adults (18 and over) with chronic migraine.
Bursa and hip injections
A bursa injection helps to reduce the pain in the buttocks, hips or upper legs in patients who have bursitis (swollen and irritated bursa). A bursa is a small pad that is filled with fluid and acts as a cushion between bones, muscles, and tendons. During the procedure, the bursa is injected with a mixture of a local anesthetic to numb the area, and a steroid, help lower the swelling.
Diagnostic medial branch blocks
A diagnostic medial branch block is a test to find the cause of neck and back pain. During the test, the doctor will inject a numbing medication around the nerve that supplies the facet joints. These are the joints in the spine that allow a person to bend and twist their neck and back. The amount of pain relief after the injection helps determine the cause of the pain and proper treatment.
Epidural steroid injections
An epidural steroid injection places a steroid into the epidural space, which is located just outside the covering of the spinal cord. Nerves travel through the epidural space to the neck, arms, back, and legs. Different types of spine problems can cause inflammation in these nerves, often resulting in pain. By reducing inflammation, the pain may decrease.
Intrathecal pump therapies
An intrathecal pump is an implant that delivers medication directly into the intrathecal space around the spinal cord to relieve chronic pain or spasticity. An initial trial determines whether pain can be successfully controlled with medications administered in the spinal canal via a needle before implantation.
Indirect spinal decompression
Indirect spinal decompression uses a device (interspinous spacer) that is implanted between the vertebrae to indirectly decompress spinal stenosis and relieve patients of the symptoms of neurogenic claudication, which includes pain or pressure when standing or walking. This option is best for patients whose symptoms have not been well controlled with physical therapy, medication, or spinal injection, and for those patients who do not want, or are not good candidates for, more invasive spinal interventions.
Intra-articular hip ejection
An intra-articular hip injection is a procedure used to treat hip and groin pain. Usually, this pain comes from inflammation that happens from daily wear and tear. In some patients, the pain is from an injury or a birth defect. This type of procedure should reduce the pain and improve the motion in the hip.
A local anesthesia and steroid are injected directly into a joint. Typically, these injections are given in the knee, shoulder, ankle, and elbow.
Occipital nerve blocks
An occipital nerve block is used to treat headaches as well as pain in the neck and back of the head. This pain is caused by inflamed (swollen) or injured occipital nerves. Common causes of swollen occipital nerves include injury, neck muscles that are very tight, and arthritis in the neck. During the procedure, a mixture of a local anesthetic and a steroid is injected into the area around the nerves to help lower the swelling, and potentially reduce pain.
Piriformis steroid injections
A piriformis injection is used to treat pain in the buttock area. During the procedure, a steroid is injected into the piriformis, the muscle that travels behind the hip joint and over the buttocks. Sometimes the piriformis muscle can become irritated, swollen, and tight due to injury and spasm. It can also push on the nearby sciatic nerve. This can cause hip and buttock pain that can extend down the leg. The injection helps reduce swelling, decrease the pressure on the nerves, and lessen pain.
Radiofrequency denervation (RFD)
Radiofrequency denervation (RFD) is a procedure used to treat neck and back pain in patients with arthritic facet joints, the joints in the spine that allow a person to bend and twist their back and neck. Daily wear and tear can bother the facet joints and cause pain. During RFD, the nerves that send pain signals to the brain are heated with radio waves, which results in the stopping of the signal. Treatment lessens or eliminates pain usually for six to 12 months and allows for body movement.
Sacroiliac joint injections
A sacroiliac (SI) joint injection (sacroiliac joint block) is used to diagnose or treat low back pain and/or sciatica symptoms associated with sacroiliac joint dysfunction. During an SI block, the SI joints are injected with local anesthetic and steroid to reduce pain and inflammation.
Spinal cord stimulation is a way to manage various types of pain by sending electrical impulses into the spinal cord. There are several types of procedures that achieve varying results.
A spinal cord stimulator is an implanted device that sends low levels of electricity directly into the spinal cord to relieve pain. It requires two procedures to test (the trial) and implant the device (implantation).
Neuromodulation is the alteration of nerve activity through targeted delivery of a stimulus, such as electrical stimulation or chemical agents, to specific neurological sites in the body. Electrical leads on the tips of soft, thin wires are inserted into the spinal canal to stimulate either the spinal cord or peripheral nerves with an external battery during an initial trial phase. If the trial provides pain relief and allows improved function, the patient is a candidate for the second phase of the procedure, in which electrodes are re-inserted and attached to an internal battery that is implanted under the skin to emit electrical current to the spinal column.
Peripheral nerve stimulation (PNS) is a commonly used approach to treat chronic pain that involves surgery that places a small electrical device (a wire-like electrode) next to one of the peripheral nerves. (These are the nerves that are located beyond the brain or spinal cord). The electrode delivers rapid electrical pulses that feel like mild tingles (paresthesias). During the testing period (trial), the electrode is connected to an external device, and if the trial is successful, a small generator is implanted into the patient’s body.
Trigger point injections
A trigger point is a painful area in a muscle that may feel like a knot or tight area that can spread to other parts of the body. A trigger point injection is given in the painful spot to lessen the pain. The injection includes a local anesthetic and sometimes a corticosteroid. In some cases, the doctor will simply put the needle into the trigger point to break up the knot, and no medicine is needed.
Vertebral augmentation, including balloon kyphoplasty or vertebroplasty
Vertebral augmentation (VA), also known as balloon kyphoplasty (BKP) or vertebroplasty, is a minimally invasive surgical treatment to reduce pain with vertebral compression fractures. These procedures help to quickly reduce severe pain, stabilize the fracture, and restore lost height and/or shape of the broken vertebral body.
Advanced Spinal Technology and Surgical Treatment Options
The Norman Prince Spine Institute has the most advanced technology, including state-of-the-art imaging equipment, tools for minimally invasive procedures, as well as advanced surgical options including:
- Disc replacement
- Dynamic stabilization
- Gamma knife
- Highly complex spinal deformity correction with osteotomies
- Intraoperative CT scanner with image guided navigation
- Intraoperative neurophysiological monitoring capability
- Minimally invasive surgery
- Multi-planar angiography
- Percutaneous or open spinal instrumentation and fusion for back and neck pain
- Stereotactic radiosurgery
- Spinal reconstruction for traumatic spine injuries
- Trilogy IMRT
- Radical tumor resection and reconstruction
Support Services for Spinal Conditions
- Behavioral health, including psychiatry, psychology, and psychopharmacology
- Physical and occupational therapy, including both land and water therapy options
- Exercise programs
- Patient and family education
- Medication management