Patient Care

• ­Cervical or neck pain
• ­Lumbago or low back pain
• ­Sacroiliac joint pain

• ­Spondylosis and arthritis
• ­Degenerative disc disease
• ­Spinal stenosis

• ­Disease-related pain
• ­Treatment-related pain
• ­Post chemotherapy pain

• ­Tingling or numbness
• ­Chronic pain caused by injury, disease, or trauma

• ­Chiari malformation
• ­Hydrocephalus
• ­Hemorrhage

Our surgeons have expertise in the diagnosis and surgical management of all types of brain and spinal tumors, including gliomas, metastases, colloid cysts, and intraventricular tumors. To learn more, visit our Lexington Medical Center Brain Tumor Program website.

For more information about Brain Surgery for treatment of tumors, visit the Lexington Medical Center Brain Tumor website to learn more about our interdisciplinary team and customized approach to diagnosing and treating brain tumors.

­
• GammaTile® TherapyGammaTile is a Surgically Targeted Radiation Therapy (STaRT) for operable brain tumors that provides immediate radiation treatment after tumor removal. Each GammaTile has radiation sources embedded in a collagen tile that deliver a precise dose of radiation focused right where it is needed and away from healthy brain tissue.
  
  
• Stereotactic Radiosurgery – a non-invasive procedure using TrueBeam that administers highly-focused radiation therapy in order to treat tumors and other brain abnormalities.
­­
• Minimally Invasive Port Surgery for Brain Tumors – a minimally-invasive technique for removing deep brain tumors using an endoscope, minimizing trauma to the brain and surrounding nerve tissue.
­­
• Shunt Implantation – a procedure to divert cerebrospinal fluid into another body cavity to treat hydrocephalus and other spinal fluid circulation disorders.
­
• Craniotomy – a surgery done to remove tumors or abnormal brain tissue, clip off an aneurysm, or drain blood or fluid from an infection.
­­
• Biopsy – a diagnostic procedure done to collect a small amount of brain tissue or tumor to be examined under a microscope.­

A surgery performed to treat bone spurs that stick out from the edges of normal bone and cause pain as they make contact with nerves and other bones. In this surgery, the small portion of the bony section causing pain is removed.

• ­Cervical Corpectomy
• ­Lumbar Corpectomy

A decompression surgery where the ligament that runs along the back side of the spine is cut in order to relieve pressure. This surgery can also be performed to gain access to a herniated or ruptured disc in the spine, remove bone spurs known as osteophytes, to address nerve damage, or remove a tumor from the spine.

• ­Cervical Laminectomy
• ­Lumbar Laminectomy

A surgery that can be done at any level of the spine that relieves pressure caused by a herniated or ruptured disc. Often patients have this surgery to address symptoms such as pain, numbness, and weakness.

• ­Anterior Cervical Discectomy and Fusion (ACDF) – a minimally-invasive surgery where the damaged disc is removed and a bone graft is inserted to fill the open disc space
• ­Lumbar Microdiscectomy – A minimally-invasive version of the surgery that removes part of the lumbar disc using a laser or suction through a small incision.

A surgery that stabilizes the spine by fusing the weak vertebrae with healthy bone and addresses spinal instability associated with degenerative disc disease, scoliosis, or other problems with spinal alignment. Often a fusion requires hardware like metal rods, plates, or screws for support.

• ­Lumbar Interbody Fusion

  Anterior Lumbar Interbody Fusion (ALIF)
  Posterior Lumbar Interbody Fusion (PLIF)
  Transforaminal Lumbar Interbody Fusion (TLIF)
  Direct Lateral Interbody Fusion (DLIF)

• ­Occipital-Cervical Fusion

A procedure done to treat compression fractures in the spine caused by injury or osteoporosis.

• ­Vertebroplasty – a procedure where bone cement is inserted into the spinal fracture through a long, hollow needle to support the broken vertebrae
• ­Kyphoplasty – a procedure where a balloon is inserted and inflated to lift the compressed vertebrae back to normal height and bone cement is then inserted into the space, providing strength and support

Also known as cervical disc replacement, cervical arthroplasty is a type of procedure that involves replacing a damaged disc with an artificial disc to treat symptoms of degenerative disc disease or unresolved cervical disc herniation.

What is it?
We inject a steroid or other pain-relieving medication directly into the source of pain to reduce inflammation and numb the pain. The physician will mark the correct level to be injected and use advanced imaging to take live pictures of your spine in order to guide the needle to the right spot. 

What should I expect?
The procedure itself should take about 10 minutes. However, there can be preparations prior to the procedure including dressing into a gown and collecting vitals and pain levels. After the procedure, you may need a driver to ensure your safety. Our dedicated scheduling staff will provide you with everything you need to know in order to be prepared the day of.

Where does it take place?
The procedure conveniently takes place in our in-office procedure suite located inside Lexington Medical Park 3. However, if advanced anesthesia is required due to certain health conditions, we may schedule you at the Ambulatory Surgery Center in Lexington. 
­
Epidural Steroid Injections
These injections can be given at any level of the spine – cervical, thoracic, lumbar, or sacral. A mixture of steroids and numbing medicine will be injected into the epidural space, which is the space surrounding the spinal cord.
­
Facet Joint Injections
A mixture of steroids and numbing medicine will be injected into one of the facet joints, which are the moveable joints on either side of your spine. When the facet joints swell, it causes pressure and pain in the surrounding nerves. This injection is intended to reduce both the pain and swelling.
­
Intramuscular or Trigger Point Injections
Intramuscular injections, or trigger point injections, are intended to reduce pain in a focused muscle area. A small needle is used to inject a mixture of numbing medication and steroids into the muscle. Trigger points are located throughout the body and are typically focus areas for muscle spasms, such as in the upper back or shoulder. 
­
Sacroiliac (SI) Joint Injections
The sacroiliac is the largest joint in the body and inflammation can cause low back and buttock pain. An SI Joint Injection of numbing medicine and steroids can help relieve the pain.

What is it?
A nerve block can be diagnostic, therapeutic, or both. As a diagnostic technique, it is often performed to determine if a specific nerve is the source of pain. As a technique to reduce pain, a nerve block involves injecting a mixture of pain killer andsteroids into or near the nerves.

­What should I expect?
The procedure itself should take about 10 minutes. However, there can be preparations prior to the procedure including dressing into a gown and collecting vitals and pain levels. After the procedure, you may need a driver to ensure your safety. Our dedicated scheduling staff will provide you with everything you need to know in order to be prepared the day of.

­Where does it take place?
The procedure conveniently takes place in our in-office procedure suite located inside Lexington Medical Park 3. However, if advanced anesthesia is required due to certain health conditions, we may schedule you at the Ambulatory Surgery Center in Lexington.

­Facet Joint Block
Targets the facet joint, which can be on either side of your spine

­Medial Branch Block
Targets the nerve that feeds the facet joint

­Occipital Nerve Block
The occipital nerve is located at the base of the skull and inflammation of the surrounding tissues can cause significant pain and migraines. During this procedure, a small needle is used to inject a solution into the area around the nerves to prevent chronic cluster headaches or episodic migraines.

­Peripheral Nerve Block
The peripheral nerves are those outside of the brain and spinal cord. Any disturbances in these nerves can cause numbness, tingling or a “pins and needles” feeling. A Peripheral Nerve Block can help relieve these symptoms.

­Sympathetic Nerve Block 
The sympathetic nerves regulate part of the autonomic nervous system which controls involuntary functions such as sweating , blood flow, and some types of pain. Conditions causing chronic pain can be treated with a sympathetic nerve block

What is it?
An ablation procedure is similar to an injection in that needles are used. However, instead of administering medication, the needle is hooked up to a generator that uses radio waves to ablate, or burn, the nerve endings which block the transmission of pain signals to the brain. This results in effective pain relief that usually lasts for six months up to a year. 

­What should I expect?
The procedure itself should take about 10 minutes. However, there can be preparations prior to the procedure including dressing into a gown and collecting vitals and pain levels. After the procedure, you may need a driver to ensure your safety. Our dedicated scheduling staff will provide you with everything you need to know in order to be prepared the day of.

­Where does it take place?
The procedure conveniently takes place in our in-office procedure suite located inside Lexington Medical Park 3. However, if advanced anesthesia is required due to certain health conditions, we may schedule you at the Ambulatory Surgery Center in Lexington.

A spinal cord stimulator delivers mild electrical stimulation to nerves along the spinal column, blocking nerve activity and preventing pain signals from reaching the brain without any medications. A temporary stimulator must be placed through a procedure done at our Ambulatory Surgery Center located in Lexington.

Once the temporary stimulator is placed by one of our pain management physicians, our neurosurgery team will monitor results of the trial to determine if you are candidate for a permanent stimulator. If it is determined you are, then our dedicated staff will make arrangements for your permanent implant surgery.

BOTOX Injections are an effective and non-invasive method for treating tension, cluster, and/or chronic headaches and migraines. It is also used to prevent the recurrence of these episodes. During the procedure, the physician will determine where to inject the BOTOX which can include the muscles of the brow, eyes, forehead, side of the head, and back of the head.  These typically last about 3 months and can be repeated at that time if needed.

---

High frequency ultrasound probes are used to aid in the diagnosis of tendon, joint, soft tissue, and nerve injuries.

An EMG is a diagnostic procedure that studies the signals between your nerves and muscles. It uses tiny needle electrodes to record electrical activity in the muscle. A nerve conduction study, often done simultaneously with an EMG, uses electrode stickers on the skin surface to measure the speed and strength of signals traveling between muscles. This procedure can help determine the source of pain, tingling, or numbness so it can be treated appropriately.

Dry needling is a highly effective treatment in resolving pain and muscle tension. The treatment involves inserting a small monofilament needle in the muscle and manipulating the needle to elicit an action potential.  This therapy can be used to decrease trigger points and muscle spasms, it can also be used to retrain damaged and less effective muscles.

Manual therapy is a specialized form of physical therapy delivered by a therapist as opposed to a device or machine. Our highly-skilled physical therapists at Lexington Brain and Spine Institute have specific experience and training in manual therapy as well as manipulation of the spine. 

This is a broad category of modalities that includes treatments such as TENS (Transcutaneous Electrical Nerve Stimulation) and IFC (Interferential Current) as well as monophasic, biphasic, and Russian currents. E-Stim has been widely used to decrease pain, increase blood-flow, provide relaxation, and to retrain muscles.

Spinal Traction or Spinal Decompression can be performed in our office on the cervical and lumbar spine as well as on peripheral joints. Traction is commonly used for degenerative discs, degenerative joints, bulging discs, as well as spasms and contractures to alleviate compression and decrease pain. The decompression provides a low load and pain-free stretch over a prolonged duration.

Cold Laser Therapy uses light waves to increase blood flow, decrease nerve irritability and decrease pain.