Muskuloskeletal Procedures


Interventional 1
Interventional 2
Interventional 3

Epidural Injection


A cocktail of drugs is injected into the epidural space. Commonly used drugs are long lasting local anaesthetic and long lasting steroid, which are supposed to decrease inflammation, swelling and pain. The procedure also has diagnostic value helping your doctor to accurately identify the cause of pain.

Patient Q & A
What will happen?

The procedure is most often done on an outpatient basis.

You will arrive in the Interventional Radiology Suite where the interventional radiologist (a doctor specially trained to perform this procedure) and radiographer will explain the procedure and answer your questions. The study usually takes about 10-15 minutes but may take longer depending on the complexity of the lower spine anatomy. After completion, you will be monitored for 25-30 minutes for possible complications.

Do I need any test before the procedure?

As we need to administer contrast (X-ray dye), you should discuss any allergy history (particularly toIodine) with the radiologist prior to booking the procedure.

If you are on any form of anticoagulation or anti-platelet therapy, it will be stopped and blood tests for the assessment of coagulation profile (Pl/PTT/platelets) will be organized.

The procedure

No sedation is usually required. You will be lying on your stomach and the radiologist will identify the spot where the injection should be given (usually at the lowest part of your back). Local anesthetic will be applied under sterile conditions. The radiologist will use X-rays guidance to insert a tiny needle into the epidural space at the level of interest. Contrast will be injected to confirm good position of the needle and to assess the distribution of medication. The drugs will be slowly administered through the needle.

What will I feel? Does it hurt?

You will feel a bee sting when the doctor numbs the skin. You may feel some mild pressure duringmedication administration.

Most patient feel significant pain relief immediately after the injection. The pain may come back later in a day or tomorrow before it disappears again. The full effect of the treatment will be obvious only after 5-7 days.

What are the risks?

Risk of bleeding or infection at the injection site is extremely low.

Extremely rarely there might be temporary increase in pain when the medication is injected.

Very seldom your blood pressure may fluctuate immediately after the block and you may feel dizzy.Even if it happens, it will disappear in a few minutes. However, this is the main reason that you musthave somebody with you to drive you home.

When will I get my results?

The radiologist will be able to talk to you after the procedure, but all the relevant details will only beavailable at your official appointment with referring doctor.

When will I resume my normal activities?

You will be able to get back to your normal life the next day. You will have to avoid any heavyphysical activity in a first 24 hours.

Facet Joint Block


Facet joints are tiny joints at the back aspect of your spine. They can sometimes become inflamed and swollen resulting in back or neck pain and muscular spasm.

Patient Q & A
What will happen?

The procedure is most often done on an outpatient basis.

You will arrive in the Interventional Radiology Suite where the interventional radiologist (a doctor specially trained to perform this procedure) and radiographer will explain the procedure and answer your questions. The study usually takes about 10-15 minutes but may take longer depending on the number of joints that need to be injected. After completion, you will be monitored for 25-30 minutes for possible complications.

Do I need any test before the procedure?

Usually no tests are required.

The prodedure

No sedation is usually required. You will be lying on your stomach and local anesthetic will beapplied under sterile conditions. The radiologist will use X-rays or CT guidance to insert a tiny needle into your facet joint or in its vicinity. The drugs will be administered through the needle.

What will I feel? Does it hurt?

You will feel a bee sting when the doctor numbs the skin. You may feel some mild pressure duringmedication administration.

Most patient feel significant pain relief immediately after the injection. The pain may come back later in a day or tomorrow before it disappears again. The full effect of the treatment will be obvious only after 5-7 days.

What are the risks?

Risk of bleeding or infection at the injection site is extremely low.

Very seldom your blood pressure may fluctuate immediately after the injection and you may feeldizzy. Even if it happens, it will disappear in a few minutes. However, this is the main reason that youmust have somebody with you to drive you home.

When will I get my results?

The radiologist will be able to talk to you after the procedure, but all the relevant details will only beavailable at your official appointment with referring doctor.

When will I resume my normal activities?

You will be able to get back to your normal life the next day. You will have to avoid any heavyphysical activity in a first 24 hours.

Perineural Block


Also known as Nerve Block

A cocktail of drugs is injected around the nerve at the point where it exits the spinal canal. Commonly used drugs are long lasting local anesthetic and long lasting steroid, which are supposed to decrease inflammation, swelling and pain. The procedure also has diagnostic value helping your doctor to accurately identify the cause of pain.

Patient Q & A
What will happen?

The procedure is most often done on an outpatient basis.

You will arrive in the Interventional Radiology Suite where the interventional radiologist (a doctor specially trained to perform this procedure) and radiographer will explain the procedure and answer your questions. The study usually takes about 10-15 minutes but may take longer depending on the number of nerves that need to be infiltrated. After completion, you will be monitored for 25-30 minutes for possible complications.

Do I need any test before the procedure?

As we may need to administer contrast (Xray dye), you should discuss with the radiologist any possible allergy history (particularly to Iodine) prior to booking the procedure.

The procedure

No sedation is usually required. You will be lying on your stomach and local anesthetic will be applied under sterile conditions. The radiologist will use Xrays or CT guidance to insert a tiny needle into the vicinity of the nerve of interest. Contrast will be injected to outline the nerve and confirm good position of the needle. The drugs will be administered through the needle.

What will I feel? Does it hurt?

You will feel a bee sting when the doctor numbs the skin. If the needle touches the nerve you will have a sensation similar to electrical current down your arm or leg. You may feel some mild pressure during medication administration.

Most patient feel significant pain relief immediately after the injection. The pain may come back later in a day or tomorrow before it disappears again. The full effect of the treatment will be obvious only after 57 days.

What are the risks?

Risk of bleeding or infection at the injection site is extremely low.

Very seldom your blood pressure may fluctuate immediately after the block and you may feel dizzy. Even if it happens, it will disappear in a few minutes. However, this is the main reason that you must have somebody with you to drive you home.

When will I get my results?

The radiologist will be able to talk to you after the procedure, but all the relevant details will only be available at your official appointment with referring doctor.

When will I resume my normal activities?

You will be able to get back to your normal life the next day. You will have to avoid any heavy physical activity in a first 24 hours.

Sacro-iliac Joint Block


Sacro-iliac joints connect your spine to the pelvis. They can sometimes become inflamed and swollen resulting in lower back pain and muscular spasm.
 
A sarco-iliac joint block is a combination of commonly used local anesthetic and long lasting steroid. These drugs decrease inflammation, swelling and pain. The procedure also has diagnostic value helping your doctor to accurately identify the cause of pain.
Patient Q & A
What will happen?

The procedure is most often done on an outpatient basis.

You will arrive in the Interventional Radiology Suite where the interventional radiologist (a doctor specially trained to perform this procedure) and radiographer will explain the procedure and answer your questions. The study usually takes about 10-15 minutes but may take longer depending if both sides need to be injected. After completion, you will be monitored for 25-30 minutes for possible complications.

Do I need any test before the procedure?

Usually no tests are required

The procedure

No sedation is usually required. You will be lying on your stomach and local anesthetic will be applied under sterile conditions. The radiologist will use X-rays or preferably CT guidance to insert a tiny needle into your sacroiliac joint or in its vicinity. The drugs will be administered through the needle.

What will I feel? Does it hurt?

You will feel a bee sting when the doctor numbs the skin. You may feel some mild pressure during medication administration.

Most patient feel significant pain relief immediately after the injection. The pain may come back later in a day or tomorrow before it disappears again. The full effect of the treatment will be obvious only after 5-7 days.

What are the risks?

Risk of bleeding or infection at the injection site is extremely low.

Very seldom your blood pressure may fluctuate immediately after the injection and you may feel dizzy. Even if it happens, it will disappear in a few minutes. However, this is the main reason that you must have somebody with you to drive you home.

When will I get my results?

The radiologist will be able to talk to you after the procedure, but all the relevant details will only be available at your official appointment with referring doctor.

When will I resume my normal activities?

You will be able to get back to your normal life the next day. You will have to avoid any heavy physical activity in a first 24 hours.

Shoulder Joint Block


Also referred to as Rotator Cuff Block

A shoulder joint block is a combination of commonly used local anesthetic and long lasting steroid injected into the joint. These drugs decrease inflammation, swelling and pain. The procedure also has diagnostic value helping your doctor to accurately identify the cause of pain.

Patient Q & A
What will happen?

The procedure is most often done on an outpatient basis.

You will arrive in the Interventional Radiology Suite where the interventional radiologist (a doctor specially trained to perform this procedure) and radiographer will explain the procedure and answer your questions. The study usually takes about 10-15 minutes but may take longer depending if both sides need to be injected. After completion, you will be monitored for 25-30 minutes for possible complications.

Do I need any test before the procedure?

Usually no tests are required.

The procedure

No sedation is usually required. You will be lying on your back or sitting and local anesthetic will be applied under sterile conditions. The radiologist will use ultrasound guidance to insert a tiny needle into your shoulder joint at the point of interest. The drugs will be administered through the needle.

What will I feel? Does it hurt?

You will feel a bee sting when the doctor numbs the skin. You may feel some mild pressure during medication administration.

Most patient feel significant pain relief immediately after the injection. The pain may come back later in a day or tomorrow before it disappears again. The full effect of the treatment will be obvious only after 5-7 days.

What are the risks?

Risk of bleeding or infection at the injection site is extremely low.

Very seldom your blood pressure may fluctuate immediately after the injection and you may feel dizzy. Even if it happens, it will disappear in a few minutes. However, this is the main reason that you must have somebody with you to drive you home.

When will I get my results?

The radiologist will be able to talk to you after the procedure, but all the relevant details will only be available at your official appointment with referring doctor.

When will I resume my normal activities?

You will be able to get back to your normal life the next day. You will have to avoid any heavy physical activity in a first 24 hours.

Vertebroplasty


Percutaneous vertebroplasty is a procedure used to treat painful compression fracture of the vertebra – the small bones of the spine. It consists of placing a hollow needle into the crushed bone and administering special medical cement called PMMA.

Patient Q & A
What will happen?

Hospital admission is not a prerogative for the procedure but as everybody is different, you may need to stay in hospital and the length of hospitalization may vary.

You will arrive in the Interventional Radiology Suite where the interventional radiologist (a doctor specially trained to perform this procedure) and radiographer will explain the procedure and answer your questions. The study usually takes about 60 minutes but may take longer if more than one bone is crushed. After completion, you will be monitored for 2 hours for possible complications.

Do I need any test before the procedure?

You will be asked to have following blood tests:

PI/FIT/Platelets — to check if your blood clots normally and to assess the risk of post procedural bleeding.

You will need limited MRI study of your back, which will look for the presence of edema in the crushed bone and confirm that you will benefit from the intervention.

The vertebroplasty procedure

You will have a drip placed in the arm for vascular access. Mild sedation might be required. You will be lying on your stomach and a small incision will be made on your back under local anesthesia and sterile conditions. The radiologist will use X-rays to determine the best angle to place the needle into the fractured vertebra. The doctor may decide that in your particular case, CT guidance will allow more accurate control for the needle positioning.

The cement will be placed into the desired place under direct control of X-rays.

After the completion you will be lying flat on your back for one hour and will be allowed to sit for the next hour. If no complications occur, you will be discharged.

Does it hurt?

You will feel a bee sting when the doctor numbs the skin. You may feel some pressure and discomfort when the needle is put in place. We may need to give you extra medication to help you relax and to reduce your pain.

Most patients feel significant relief of the pain immediately, but sometimes it may take a few days to a month for you to become symptom free. In the latter case you will still need some medication for a week or two to control the pain.

What are the risks?

Bleeding at the puncture site happens seldom and is usually minimal.

Infection can be expected with prolonged procedure. We may need to give you antibiotics to prevent it.

The possibility of cement leak happens seldom and is minimized by careful monitoring of its administration. It usually does not cause serious problem unless the significant amount of cement moves towards spinal canal.

When will I get my results?

The radiologist will be able to talk to you after the procedure and advise if the intervention was a technical success.

When will I resume my normal activities?

You should relax for the rest of the day but if no complications occur, you will be able to get back to your normal life the next day.