Minimally Invasive Spine Procedures

Evidence-Based Pain Treatments

Have you explored all your options for treating back pain, nerve pain, or neck pain? Did you know our pain management doctors can simultaneously diagnose and relieve spinal pain without surgery?

If you’re experiencing debilitating spinal or nerve pain that is keeping you from doing what you want, consider what we have to offer. Our doctors have decades of experience with what you’re going through, and we utilize the most effective and minimally invasive spine procedures to help our patients.


A discogram is a diagnostic test in which contrast dye is injected into a disc in the patient’s spine. Discograms help to pinpoint which disc is causing back or leg pain. It is often done as a pre-surgical evaluation to consider what further treatment is needed. A post-disco CT scan will be scheduled to show where and how the disc is damaged.

During the procedure, you may be given medication to help you relax. The area to be injected is numbed with a local anesthetic. The needle is placed into each disc being tested. Then the contrast dye is injected into one of the discs in the spine.

Pain may increase when the contrast dye is injected. Your pain management doctor will ask if your pain is in the same place as the pain you usually feel. At least two discs will be tested for comparison.

After the discogram, you will be given pain medication. The procedure takes approximately 30-45 minutes to complete. Following the procedure, you will recover for 15-20 minutes before going home with a driver. You should take it easy the day of the procedure and resume your normal activities the next day.


Nucleoplasty is a minimally invasive procedure developed to treat patients with a contained or mildly herniated disc.

Nucleoplasty does not involve any incisions. A special access needle is placed into the disc under fluoroscopy guidance. A wand-like device is then inserted through the needle and into the disc. The device uses heat to remove disc material and seal the channel made by the needle.

During the procedure, you may feel a sense of pressure or mild discomfort while the needle is inserted into the disc. The procedure takes about 30 to 45 minutes to complete. Following the procedure, you will be monitored for 15-20 minutes before having someone drive you home.

Intradiscal Electrothermal Therapy

Intradiscal electrothermal therapy (IDET) is a non-surgical procedure used to treat chronic back pain.

A catheter that uses heat modifies the protein wall of the disc and reduces the amount of disc material that causes nerve irritation. Under fluoroscopic guidance, the catheter is guided into the patient’s disc through a spinal needle and is heated for about 15-20 minutes. You may experience pressure during the procedure while the needle is placed into the disc. IDET can be done in one or multiple discs.

Following the procedure, you will recover for 15-20 minutes before being released to go home with a designated driver. As a precaution, you should avoid strenuous activity the day of the procedure, and you can resume your normal activities the next day.

Spinal Neurostimulation: Intrathecal Spinal Pump Implant

An intrathecal pump is offered to patients with chronic and severe pain who have not adequately responded to other treatment modalities. This computerized device delivers concentrated amounts of pain medication into the spinal cord area through a small catheter to help decrease or eliminate the need for oral medications.

You must first be deemed eligible for an intrathecal pump implant. For patients who qualify, the pump can significantly decrease pain and improve their quality of life.

First, you will be evaluated by a medical psychologist with experience in chronic pain management. If the psychologist concludes that you are an appropriate candidate for the intrathecal pump, you will then undergo an intraspinal medication trial.

The trial will help determine if you have any problems with the medication that may be used in the infusion pump and to see if the medication will be effective in providing you with the desired level of pain relief. If the trial is successful, you will be referred to a surgeon to implant the pump, which is a permanent device that is placed under the skin.

During the procedure, tubing is placed in the midline of the lower back and a local anesthetic is injected through it to confirm adequate placement and to obtain anesthesia on the entire surgical field.

The intrathecal pump is then placed on the side of the abdomen. You should feel that your pain is under control or quite less. The pump will be adjusted electronically to deliver adequate amounts of medication.

After the procedure, you will recover for about four hours and will be allowed to go home with a driver.

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