At Mount Sinai, our team of interventional neuroradiologists is highly effective in reversing life-threatening conditions and relieving long-term pain caused by spinal malformations, spine nerve irritation, and vertebral compression fractures. We treat a wide range of spinal conditions. The most common are:
Spinal Malformations happen when the tiny blood vessels, called capillaries between the arteries and veins become tangled on, near, or in the spinal cord. These malformations may cause abrupt pain; progressive loss of strength or sensation; or bowel, bladder, or sexual dysfunction. We usually use magnetic resonance imaging spinal angiography to diagnose spinal malformations and to delineate the spinal cord vascular anatomy, which is essential for planning treatment. If left untreated, a spinal arteriovenous malformation can permanently damage your spinal cord by causing spinal tissues to die or a blood rupture (hemorrhage) in the spinal cord.
Spinal irritation can happen when a herniated disc or degenerative arthritis presses on your spinal nerves. Spine inflammation may cause back muscle spasms and pain that “radiates” to your hands and feet.
Vertebral compression fractures are usually the result of a trauma, fall or a weakening of the bone due to osteoporosis or another underlying metabolic condition. Patients with multiple myeloma or patients whose cancer has spread to the spine are also subject to vertebral compression fractures. The pain is often severe and debilitating.
Our multidisciplinary team of specialists, including endovascular surgeons, neurosurgeons, neurologists, and neurophysiologists, works together to create and carry out your individual treatment plan.
We treat spinal cord AVMs with embolization
If you have spinal nerve irritation, we use imaging tests to pinpoint the precise location of the irritated nerve, nerve root, or region of the spine, followed by the use of a catheter to infuse medication to provide relief. We use the following procedures to treat pain related to spinal nerve irritation or compression.
- Epidural, transforaminal, and nerve root injections can relieve the pain and inflammation related to nerve irritation. We inject both an anesthetic and a steroid into the affected area.
- Medial branch block and facet joint injections can treat pain from facet degenerative disease or trauma. Once we identify the painful facet joint or the medial branch (nerve supply to facet joint), we inject a combination of anesthetics and steroids.
- Radiofrequency ablation often works for people who respond well to medial branch blocks. We place a probe at the location of the diseased facet joint nerves and send a strong radiofrequency pulse through the probe, destroying the nerve and providing significant pain relief.
- Sacroiliac joint injections are effective when your sacroiliac joint, which connects the spine and pelvis, wears away, resulting in severe pain in that region and in your pelvis, lower back, groin, legs, or abdomen. We inject an anesthetic and a steroid directly into your sacroiliac joint. For both short- and long-term pain relief.
If you have a vertebral compression factor, we start with pain medication, bed rest, physical therapy, and bracing. If your pain continues, we may try one of the following:
- Vertebroplasty and kyphoplasty involve injecting specially formulated cement directly into the damaged vertebrae to destroy painful nerve fibers and strengthen the fractured or diseased bone. In vertebroplasty, we use a needle to inject the cement. In kyphoplasty, we use minimally invasive neuroendoscopy to inflate a tiny balloon near the vertebra to create an opening for the cement.
- Chemotherapy and/or radiation therapy are often effective along with vertebroplasty and kyphoplasty to stabilize bone that is diseased by cancer. We work closely with oncologists and orthopedists to coordinate this aspect of your care..