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Microtherapy

What is Microtherapy?

Microtherapy of the spine is a minimally invasive procedure. It allows your physician to apply pain medication, cortisone and/or radio frequency energy (heat) into painful spinal areas. The injection needles are positioned under X-ray or CT guidance. Before applying the medication the position of the injection needles is checked and, if necessary, corrected during examination.

Where can Microtherapy be done at the BGU Frankfurt?

If your doctor has prescribed Microtherapy you will get an appointment in our clinic at short notice. Generally, Microtherapy is an outpatient treatment and you will be able to get up and walk immediately after the procedure. You should, however, not drive a motor vehicle within the following 6 hours.

What types of Microtherapy are offered at the BGU Frankfurt?

Facet Joint Injection

With the patient in prone position, a thin hollow needle is inserted under X-ray or CT guidance directly into the painful vertebral joint. The facet joint is then filled with an anesthetic medication for diagnostic purpose or with cortisone for therapeutic purpose.

Facet joint injections are usually done in case of back pain caused by degenerative vertebral facet joints.

Sacroiliac Joint Injection

With the patient in prone position, a thin hollow needle is inserted under X-ray or CT guidance directly into the sacroiliac joint. Then, a small mixture of a local anesthetic and cortisone is slowly injected into the painful joint.

Sacroiliac Joint Injections are usually done in case of low back pain caused by a blocked or degenerative sacroiliac joint.

Facet Joint Denervation

With the patient in prone position, a thin hollow needle is advanced under X-ray or CT guidance to the joints, which have already been proven to be painful by a diagnostic form of facet joint injection. Then a mild electrical current is passed through the needle to assure it is next to the painful medial sensoric branch of the nerve root and far enough from the motoric nerve root. This should briefly recreate the usual low back pain. If properly placed, the needle tip is electrically heated for about 60 seconds in order to cauterize the medial branch of the nerve root. This process will be repeated for every painful vertebral joint.

Usually, Facet Joint Denervation is done in case of back pain caused by degenerative vertebral joints and after successful temporary pain relief induced by a facet joint injection.

Sacroiliac Joint Denervation

If you had a positive result from a sacroiliac (SI) joint injection the denervation should provide sacroiliac pain relieve lasting several months.

Usually, sacroiliac denervation is done in case of back pain caused by degenerative sacroiliac joints and after successful temporary pain relief induced by a sacroiliac joint injection.

Discography

Discography is a diagnostic procedure in which an X-ray contrast liquid is injected into a disc while taking an X-ray of the spine.

Discography is a specific test, which is only done if an advanced treatment, such as surgery, has to be considered.

Epidural Steroid Injection (ESI)

With the patient in prone position, a thin hollow needle is inserted under X-ray or CT guidance into the spinal canal. Then, a small amount of cortisone is injected into the space outside the dura (epidural space).

Epidural Steroid Injections are usually done in case of back and/or leg pain caused by spinal degeneration associated with a narrowing of the spinal canal or herniated vertebral disc.

Periradicular Therapy (PRT)

With the patient in prone position, a thin hollow needle is advanced under X-ray or CT guidance in the immediate vicinity of the selected painful nerve root. Then, a local anesthetic and a small amount of cortisone are applied.

Periradicular Therapy (PRT) is usually performed in case of leg pain caused by a herniated disc or a bony constriction of the nerves in the foraminal area.

When should Microtherapy NOT be performed?

Microtherapy should not be performed on patients who suffer from a coagulation disorder. Patients, who are on platelet aggregation inhibitors e.g. Phenproucumon [Marcumar] or Clopidogrel, have to replace these medications by others such as Heparin or temporarily discontinue prior to injection.
Please contact your primary care physician or cardiologist if you do not know whether your medication can be replaced or discontinued. In case of allergies to the medications used during Microtherapy or if you suffer from a spinal or meningeal inflammation Microtherapy cannot be performed.

How long does the effect of Microtherapy last?

In case of diagnostic injection, the effect of the injections only lasts a few hours. In case of therapeutic injections, the effect can last several days or weeks. If a denervation has been performed, pain relief can last up to several years.

Photos

Microtherapy 1a
Microtherapy 1b
Microtherapy 1c
PRT L5 left sidePRT L5 left side
EDT at L4-5 levelEDT at L4-5 level

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