Latest Techniques
The Platelet Rich Plasma (PRP) therapy (also known as Stem Cell Therapy) is a revolutionary pain treatment therapy involves injecting platelets from the patient's own blood to rebuild a damaged tendon or cartilage. It has been successful in not only relieving the pain, but also in jumpstarting the healing process.
The patient’s blood is drawn and placed in a centrifuge for 15 minutes to separate out the platelets. The platelet-rich plasma is then injected into the damaged portion of the tendon or cartilage.
Platelets are portion of the blood that circulate around the body equipped to help with blood clotting if you have a cut, cracked bone, an injury that bleeds inside or any other kind of injury. Besides encompassing clotting factors, the platelets release growth factors that help begin the healing sequence. With a concentrated quantity of platelets, bigger amounts of these growth factors are released to kindle a natural healing reaction. Plasma is the clear portion of the blood in which all the other blood elements such as platelets, red blood cell sand white blood cells travel.
Maximum PRP injections can be done on an outpatient basis, typically in the office setting. Treatment with PRP can be categorized into two steps: organizing the platelet-rich plasma for injections and then injections into the affected part. First, blood is drawn from your arm and used to produce the injected fluid. The blood is placed in a centrifuge. The centrifuge whirls the blood fast enough to segregate it into layers based on weight. Heavier portions stay on the bottom. Platelets and white blood cells draw outjust above the red blood layer. Lighter particles make up the top layer in the test tube. Once your blood is drawn, the sample is prepared straightaway and you can have the inoculation as rapidly as 20 minutes later. Once the PRP has been prepared, it is vaccinated into the impairedregion. You will not be asleep or anesthetized during this procedure.
Percutaneous disc decompression: Nucleoplasty, Intradiscal electrothermal therapy (IDET)
Percutaneous disc decompression is a treatment option for people suffering prolonged and severe back pain resulting from a disc herniation (bulge) that did not respond to conventional treatment. Nucleoplasty is a minimally invasive alternative for treating the disc bulge. Performed in an outpatient setting, this procedure uses a needle that emits radio waves to shrink a disc bulge by dissolving excess tissue. This relieves the pressure inside the disc and on the nerves responsible for causing pain. The procedure should take less than one hour.
Procedure Preparation
This procedure will be done in a hospital setting. After your initial consultation in our office, you will set up an appointment with our staff for day case admission.
Please bring any previous imaging study results (MRI, CT, x-rays) such as films, reports, or CD-ROMs to your initial visit. If you do not have current images, we may refer you to have studies done prior to the procedure.
You will receive specific instructions to follow prior to the procedure with regard to eating and drinking.
You will need someone to drive you home and stay with you for 12 hours post-procedure due to the effects of sedation medications. Please make any necessary arrangements.
Please notify our physician if you are nursing or if there is a chance you may be pregnant.
Please be prepared to discuss any medications that you are currently on with our physician, or bring your medication bottles with you to your initial appointment.
During the Procedure
Nucleoplasty is an advanced injection procedure that is performed in a local hospital with our staff.
You will be awake during the procedure to provide important feedback to the physician, but you will be under a sedative to diminish your anxiety and any discomfort.
After you are in position on the table, your lower back will be numbed with a local anesthetic.
Under x-ray guidance (fluoroscopy), a small, tube-like needle is placed into the center of your bulged disc.
A small, specialized wand is inserted through the needle, where it is heated to create a series of channels within the disc by dissolving tissue.
By reducing the amount of excess tissue within the disc, this treatment can reduce the size of the bulge and also relieve pressure inside the disc, as well as on the adjacent nerves.
The wand will then be slowly withdrawn to its original position while thermally sealing the new channel.
You will be closely monitored during your procedure.
The number of channels created is dependent on the disc size. At the end of the procedure, the wand and needle will be removed.
After the Procedure
A small bandage will be placed over the needle insertion site and you will be taken to the recovery area until you are ready to go home.
Adult supervision is necessary for the remainder of the day due to the effects of sedation.
You will receive general activity and rehabilitation guidelines.
You may experience increased symptoms for 7-10 days until the disc begins to heal.
Prescription medications may be given to relieve these symptoms.
Possible side effects
Complications are rare, but we encourage you to keep track of any symptoms you experience after the procedure and report them to your physician at your follow up visit 7-14 days after the procedure.
A full course of physical therapy will help you to fully recover, strengthen your back and core muscles, and maximize your recovery.
Percutaneous discectomy: DISKOM
Percutaneous discectomy (percutaneous means ‘through the skin’) is a therapeutic treatment for patients suffering from low back and leg (radicular) pain due to contained herniated discs. The procedure is for those who have had failed conservative treatments and are interested in trying minimally invasive options prior to considering traditional back surgery.
Procedure Preparation
There is very little preparation needed for this procedure. In fact, you may decide to go ahead with this procedure during your initial consultation in our outpatient clinic. The procedure will be fully explained to you before you decide to proceed.
Please bring any previous imaging study results (MRI, CT, x-rays) such as films, reports, or CD-ROMs to your initial appointment. If you do not have current images, we may refer you to have them done prior to the procedure.
If you come by car, you will need a driver to take you home after your appointment. You will be able to go home unaccompanied via subway or taxi.
Please notify our physician if you are nursing or if there is a chance you may be pregnant.
During the Procedure
Once you arrive, you will be given an IV and a light sedative, if desired and appropriate.
Your physician will review all current prescriptions, MRIs, x-rays and reports.
The procedure will be performed under x-ray-guidance (fluoroscopy) to verify accurate positioning of the discectomy probe.
The discectomy probe (DISKOM) removes disc tissue, which may relieve painful pressure on the surrounding nerves.
The procedure generally takes 15 minutes to an hour.
Throughout the procedure, we will monitor your condition and comfort level closely.
You will be asked to rest in our recovery area until you are ready to go home.
After the Procedure
We will provide patients with activity and physician rehabilitation guidelines.
Adult supervision is necessary for the remainder of the day due to the effects of sedation.
Apply ice to the area for 1-2 hours per day for 3 days.
Prescription medications may be given to relieve any pain symptoms.
With appropriate follow-up care, pain will be reduced.
Physical therapy and home exercise is optimal for your speedy recovery.