Dealing with Chronic Pain

Cryotherapy is most often used to treat nerve pain generated by peripheral nerves (nerves located outside of the spinal column). A special probe is carefully placed adjacent to a specific nerve. This is most often done with the aid of x-ray guidance. Once in the appropriate area the probe is first used to stimulate the affected nerve helping to verify correct positioning. Once certain of proper placement, the tip is cooled to temperatures between �?0 C and �?0 C absorbing heat from the surrounding tissue and causing a cryo lesion. This results in reversible but very prolonged block of the pain signal.

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Radio Frequency (RF) Nerve Ablation can be used to temporarily deactivate minor nerves around the spine. The pain generating nerves for many patients are often small, unimportant fibers which can cause severe pain. These nerves can be temporarily shut down using radiofrequency energy to heat the surrounding tissue and deactivate the pain generating nerve fibers. The procedure is performed by accessing the affected nerve under x-ray guidance. Once properly positioned, a special probe is advanced allowing the delivery of radiofrequency energy to the targeted area. Results can last from months to years.

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Discectomy of the intervertebral disc nucleus pulposus for relief of low back and radicular pain is the most commonly performed neurosurgical procedure achieving success rates in excess of 90%. Less invasive methods for discectomy and disc pressure reduction will play an important role in the future treatment of patients suffering from disc herniations.

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The Dekompressor�?1.5 mm Percutaneous Lumbar Discectomy Probe utilizes a highly efficient method for removal of intervertebral disc nucleus pulposus through a smallest available channel allowing discectomy entirely under fluoroscopic control.

Discectomy using the Dekompressor�?may result in:

a reduction in the production of perineural scarring and postoperative fibrosis

a reduction in permanent structural alterations including those produced by: invasion of the spinal canal dissection of the ligamentum flavum removal of lamina disruption of the disc annulus

a decrease in: anesthesia procedure time recovery time

a decrease in complication and morbidity rate

a decrease in postoperative spinal instability

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IntraDiscal ElectroThermal Annuloplasty (IDEA) is a new technology gaining widespread acceptance for treating discogenic (disc related) pain. Patients who are good candidates for the IDEA procedure have low back pain due to disc herniations in the lumbar spine, with little or no radiation of pain into their legs. With the guidance of x-ray, the disc is accessed and a small thermal catheter is advanced into the disc. Once properly positioned, the catheter is gradually heated, raising the temperature inside the disc. The heat contracts and thickens the protein of the disc wall as well as deactivating many of the nerve endings responsible for the pain in the damaged disc.

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Epiduroscopy is a new method of directly visualizing and treating the inside of the spinal column using direct vision. A small flexible fiberoptic catheter is inserted through a tiny incision and the areas of concern can be visualized on a video monitor. Adhesions, or scar tissue, that may be pulling on or irritating specific nerve roots can often be effectively treated using this device.

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