Specialized Diagnostic Procedures:

Lumbar CT/discography - A dynamic intradiscal contrast injection under fluoroscopic control followed by axial CT imaging to precisely diagnosis disc disorders.
Diagnostic lumbar facet joint nerve blocks - To diagnose and treat low back pain caused by facet joint syndrome or thoracolumbar syndrome. Patients often describe unilateral low back pain with this syndrome.
Diagnostic nerve root sleeve blocks in the lumbar and cervical spine - To identify and treat isolated nerves responsible for radicular pain. This test also aids surgical planning in complex cases that require only specific areas of decompression to solve a patient’s pain or radiculopathy.
Percutaneous vertebral biopsies – To diagnose cancer or infection.

Pain Management Procedures:

Epidural steroid injections - In the cervical and lumbar spine using fluoroscopic control for precise needle placement ensuring accurate delivery of the corticosteroid medication.
Transforaminal steroid injections - For treatment of specific cervical and lumbar radiculopathies.
Nerve root sleeve blocks - Another technique to treat cervical or lumbar radiculopathies.
Facet joint nerve blocks - In the cervical, thoracic, and lumbar regions for pain relief especially in elderly arthritic patients who are not good surgical candidates.
Vertebroplasty with bone cement - A procedure to percutaneously inject bone cement into fractured vertebrae to stop pain and prevent further bone collapse in elderly patients.
Sacroiliac joint injections - To treat painful SI joint pathology.

Intradiscal electrothermal therapy (IDETT) - A technique to treat a torn lumbar disc. A small heat probe is percutaneously guided into the disc and heated adjacent to the tear to stop pain caused by small nerve fibers around the tear.
Kyphoplasty or OptiMesh procedure - Percutaneous techniques to restore vertebral height after a compression fracture. These techniques are designed to help prevent the progressive deformity that occurs when multiple compression fractures are left untreated in osteoporotic patients.
Radiofrequency lesioning of dorsal spinal rami - A percutaneous technique to destroy pain-producing spinal sensory nerves called spinal rami adjacent to the facet joints. These nerves are frequently responsible for causing unilateral low back pain called facet joint syndrome.
Percutaneous endoscopic disc surgery - To remove lumbar disc herniations through a small tube.
Percutaneous spinal fusion - Using various techniques including percutaneous pedicle screws, OptiMesh spinal implants, Axialif paracoccygeal spinal screw, and Xlif lateral fusion device.
X-stop spinous process extension block - To treat lumbar stenosis.

Artificial disc replacement surgery - In the lumbar spine.
Open laminotomies and discectomies - In the cervical, thoracic and lumbar spine.
Decompressive extensive laminectomies - In the cervical and lumbar spine for cervical and lumbar stenosis respectively.
Anterior cervical discectomy and fusion - For disc herniations and radiculopathy.
Multilevel anterior vertebrectomies and fusion with instrumentation - In the cervical, thoracic, and lumbar spine for anterior cord compression and deformity.
Decompressive laminectomies with posterior instrumented fusions - In the cervical and lumbar spine for cervical and lumbar stenosis with deformity and/or instability.
Combined anterior/posterior approaches to thoracic and lumbar pathology including tumor and deformity. Using appropriate instrumentation including PEEK structural implants, titanium cages, pedicle screws, and various anterior and posterior plate constructs.
Complex revision spinal surgeries - Many patients have been referred to Dr. O'Brien after multiple previously failed spine surgeries.