Orthopedic (Bone)

The Orthopedic Procedures our doctors can perform fall under one of these categories.

• Bone Biopsy: removal of bone material for examination.
• Discography: diagnostic procedure used to examine the discs between the vertebrae in the spine.
• Facet Nerve Denervation: relieves pain caused by facet arthopathy.
• Intradiscal Electrothermal Therapy (IDET): procedure reducing the bulk of a herniated disc to reduce pressure on surrounding nerves.
• Nucleoplasty: percutaneous removal of disc tissue to reduce pressure on surrounding nerves.
• Radiofrequency Ablation (RFA): radiofrequency treatment of painful benign lesions such as osteoid osteomas.
• Spinal Cord Stimulator: implanted device used to relieve chronic back pain
• Steroid Injections: injection of steroids into joints or discs to relieve pain caused by herniated discs, facet arthopathy, or sacroiliac joint disorders.
• Vertebroplasty / Khyphoplasty: repair of vertebral fractures using bone cement directly applied to the vertebrae.

Bone biopsy is used to test for abnormal cells in bones. A slender needle is guided via fluoroscopy to the precise location of the biopsy, then a small amount of material is removed for examination.

Bone biopsy is a needle-based procedure performed at our freestanding facility in Dayton, Ohio. The procedure will take about an hour and requires no overnight stay.

Discography is a diagnostic procedure used to examine the discs between the vertebrae in the spine to determine whether there is damage to the discs, such as an tear in the skin of the disc (annulus) or a herniation. Our doctors examine the resulting discogram to pinpoint the cause of your back pain.

Discography is minimally invasive procedure in which x-ray contrast dye is injected into the discs in your spine. An x-ray is then done to examine the discs for signs of fissures in their surface or a bulge that can signify herniation.

It requires no stitches, no general anesthesia, and it has a very quick recovery time. Our doctors will recommend treatment options to relieve your back pain based on the results of the discogram.

Discography is a needle-based procedure that our doctors perform at our freestanding facility in Dayton, Ohio. The procedure takes about an hour and requires no overnight stay.

Median or facet nerve denervation is a procedure used to treat facet arthopathy by disabling the nerves in the facet joints so that they can no longer transmit pain response to the brain. This is an acceptable treatment to achieve pain relief when it has been suitably determined that the pain is chronic and is definitely caused by the facet joint.

Our doctors perform facet nerve denervation by using radiofrequency to disable the small nerves that serve the facet joint. You’ll be able to return to normal activities after a few days, and full pain relief is usually achieved in two or three weeks. Pain relief generally lasts until the nerves regrow, which can take nine to fourteen months. Some people find that their pain never returns. If your pain does return, the procedure can be done again

Facet nerve denervation is a needle-based procedure that our doctors perform in our freestanding facility in Dayton, Ohio. The procedure takes about an hour and does not require an overnight stay.

Intradiscal electrothermic therapy (IDET) or intradiscal electrothermal annuloplasty (IDEA) is a minimally invasive procedure to treat back pain caused by disorders of the spongy discs between the vertebrae of your spine, such as disc herniation.

Before IDET is performed, our doctors will perform a discogram to establish that a damaged disc is indeed causing your pain, and if so, which disc or discs is responsible.

IDET is a minimally invasive procedure in which a needle is guided via fluoroscopy (live X-ray) to the precise location of a damaged disc. Once the needle is in place, a catheter made of thermal resistive coil is threaded into the needle and into the disc. The catheter is heated, causing the collagen within the disc to contract, effectively reducing the herniation and improving the internal structural integrity of the disc. It also seals any fissures in the disc’s outer covering (annulus) and desensitizes the tiny nerves that are associated with that disc.

Recovery from this procedure is gradual. Significant pain relief should be experienced within 8 weeks, and full healing occurs after about 4 months.

IDET is a needle-based procedure that our doctors perform in our freestanding facility in Dayton, Ohio. The procedure takes about an hour and requires no overnight stay.

Discectomy is the removal of a part of the spongy disc between vertebrae in your spine, and is used to relieve the pain caused by disc disorders (herniated or ruptured discs), in which disc material is bulging out and pressing on the nearby nerves. “-ectomy” means removal

Discectomy has typically been performed surgically, but technological advancements have made it possible to perform discectomy percutaneously, which requires only a tiny incision that does not require stitches and heals very quickly. “percutaneous” means “through the skin”

Nucleoplasty is a discectomy in which material is removed from the center of the disc. Our doctors perform two types of discectomy: percutaneous nucleoplasty and DISC Nucleoplasty.

DISC Nucleoplasty is a specific type of percutaneous nucleoplasty that uses Coblation©, an innovative plasma technology that can remove tissue from the disc with the DISC Nucleoplasty SpineWand, which is inserted through a hollow needle that is guided into the disc with fluoroscopy (live X-ray).

DISC Nucleoplasty and percutaneous nucleoplasty are needle-based procedures that are performed in our freestanding facility. The procedure takes about an hour and no overnight stay is required.

Radiofrequency ablation (RFA) is a procedure that uses radio waves to destroy damaged or abnormal tissue. It may be used to close a damaged vein to force healthy veins to take over its function. It may be used to destroy cancerous tumors in the liver or lungs.

When RFA is used to treat tumors, a hollow needle is guided directly into the tumor using fluoroscopy (live X-ray) for guidance to ensure precise placement. Once the needle is in place, a set of tiny metal wires is extended and radiofrequency energy is applied.

When RFA is used to treat damaged or malformed blood vessels, the tiny metal wires are transported to the correct location with a catheter that travels through your blood vessels.

Radiofrequency ablation (RF ablation) is used to treat benign tumors, called osteoid osteomas, that usually occur in teenagers and young adults. These painful lesions can be treated by using radiofrequency energy to destroy the lesions and immediately adjacent surrounding tissue, which relieves the pain.

This needle-based procedure is performed at our freestanding facility in Dayton, Ohio, and requires no overnight stay.

A spinal cord stimulator is an implanted device that can relieve chronic back pain. It is implanted in your back, and a small wire, called a lead, is inserted in between the vertebrae in your spine. The lead intercepts the pain signals and uses an electrical impulse to change your perception of them to a gentle tingling.

Spinal cord stimulators are used when the cause of the pain cannot be treated directly, such as chronic neurological pain from failed back surgery syndrome or neuropathy. The device and lead are implanted under the skin and are unnoticeable to outside observers.

Generally a 3-7 day trial is done to ensure that the spinal cord stimulator will adequately relieve your pain. If you are comfortable with the amount of pain reduction during the trial, our doctors will implant a permanent spinal cord stimulator to provide you with constant pain relief.

The comedian Jerry Lewis has been using a spinal cord stimulator to handle his chronic back pain since 2002. He experienced 100% pain relief and is now a spokesperson for Medtronic, a company that manufacturers spinal cord stimulators. You can read about his experience in an interview or watch a video interview with him to hear more about how spinal cord stimulator worked for him.

Injections of steroids are frequently used to relieve pain in a specific location. Instead of using over the counter pain medication that floods your entire system with medication, steroid injections can treat the pain and swelling directly at the source. They are also used for diagnosis — our doctors may inject a small amount of steroids to determine if the correct source of pain has been identified.

Our perform two types of steroid injections: epidural and intraarticular. Epidural injections are given into the spine, such as to treat or diagnose herniated discs. Intraarticular injections are given into joints, to diagnose or treat facet arthopathy or sacroiliac joint pain.

These injections are needle-based procedures in which our doctors use fluoroscopy (X-ray guidance) to ensure that the steroids are delivered to the precise location that is causing your pain.

Steroid injections can provide pain relief for up to a year, allowing you to proceed with rehabilitation programs that will help you return to an active and pain-free life.

This is an outpatient procedure performed at our free-standing facility. It requires no stitches, no general anesthesia, and it has a very quick recovery time. Most people experience complete pain relief immediately after the procedure; others report that their pain was gone or significantly reduced within 48 hours.

Vertebroplasty and khyphoplasty are minimally-invasive procedures that are used to treat vertebral fractures, usually caused by osteoporosis or bone tumors. The pain of vertebral fractures is caused by the compression and shifting of the damaged vertebrae, so vertebroplasty and khyphoplasty treat the pain and the fracture by shoring up the vertebrae with bone cement.

Vertebroplasty and khyphoplasty are minimally invasive procedures in which fluoroscopy (live X-ray) imaging is used to precisely place a needle at the location of the fracture. The bone cement is injected directly into the vertebrae, then allowed to harden so it can strengthen and support the vertebrae.

Vertebroplasty is appropriate for cracked or broken vertebrae, but for vertebrae that have suffered compression fractures, khyphoplasty is more successful. Kyphoplasty involves the insertion of a balloon catheter into the compressed vertebrae. The balloon is filled with bone cement and allowed to harden. This restructures and rebuilds the vertebrae so that it can provide support for the spine again.

Both vertebroplasty and khyphoplasty not only relieve the pain of damaged vertebrae, but they also prevent further damage from the original fracture.

It requires no stitches, no general anesthesia, and it has a very quick recovery time. Most people experience complete pain relief immediately after the procedure, others report that their pain was gone or significantly reduced within 48 hours.

We have the largest experience with vertebroplasty and kyphoplasty in the midwest, having performed over 2000 procedures. We have authored numerous articles on this procedures and have taught other physicians internationally.

This is a needle-based procedure that our doctors perform our freestanding facility in Dayton, Ohio. The procedure takes about an hour and requires no overnight stay.