OHIP Covered Services
Cervical Epidural Steroid Injections
Performed by Dr. Dima Rozen and his esteemed associates, this procedure is a delivery of anti-inflammatory steroids directly to the nerves in the cervical epidural space – the area around the neck that originates from the spinal cord and spreads outwards to the shoulders, upper back and down the arms.
This treatment may be chosen when pain relievers or other modalities become ineffective in treating the inflammation of these nerves and limit the patient’s ability to perform everyday tasks due to this severe pain. This treatment can be used to relieve pain caused by pinched nerves in the cervical spine and to treat conditions such as herniated disks and spinal stenosis.
No general anesthesia is required for this treatment just a local anesthetic to the skin. Once the area is numbed, a needle is inserted to the epidural space where the inflammation is located. Once needle placement is confirmed, the anti-inflammation steroid is injected to the cervical epidural space where it can work to reduce the inflammation.
The procedure lasts 15 minutes and duration can vary but typically lasts up to six months.
Caudal Epidural Steroid Injections
Performed by Dr. Dima Rozen and his esteemed associates, this procedure involves injecting an anti-inflammatory steroid into the base of the spine through the sacral hiatus where the spinal cord ends above the buttocks.
These type of injection is recommended and used for the treatment of lower back pain and leg pain caused by herniated discs, bone spurs, sciatica and Lumbar Spinal stenosis.
No general anesthesia is required for this treatment, only a local anesthetic to the skin. Once the area is numbed, a needle is inserted through the sacral hiatus with the assistance of live fluoroscopy. Once needle placement is confirmed with the injection of contrast and the epidural space is visualized, the anti-inflammatory steroid is injected to the caudal epidural space.
Each caudal injection may last for several weeks to several months and follow up with your physician is recommended.
Cervical, Lumbar and Thoracic Facet Joint Injections
Performed by Dr. Dima Rozen and his esteemed associates, this procedure involves injecting a small amount of local anesthetic and/or steroid medication into the affected joint in the spine whether it be the cervical, lumbar or thoracic facet joint.
This treatment may be chosen to address inflammation in these joints due to a variety of conditions such as osteoarthritis, degenerated discs, Spinal stenosis, or from a trauma such as a car accident.
No general anesthesia is required for this treatment only a local anesthetic to the area to be treated. Once the area is numbed, fluoroscopic guidance is used to open the inferior aspect of the affected joint. A needle is guided into the joint space and placement confirmed with the injection of contrast. Once needle placement is acceptable a mixture of local anesthetic and steroid is injected directly to the affected joint.
Duration of the treatment varies greatly but results between six hours to six months have been reported.
Lumbar Epidural Steroid Injections
Performed by Dr. Dima Rozen and his esteemed associates, this procedure is a minimally invasive procedure that can help relieve pain in the back and legs which is caused by inflamed spinal nerves. More specifically, this treatment is typically recommended for those patients who suffer pain due to Spinal stenosis, spondylolysis, herniated disc or degenerative disc or sciatica.
Pain relief may last for several weeks or several months. The goal is to reduce the patient’s pain so that they can resume normal activities.
Once the proper intra laminal segment is identified the area is localized. The epidural space is entered using a loss of resistance technique. Fluoroscopy may be used but that is at the physicians’ discretion. Once the epidural space is identified the anti-inflammatory steroid is injected.
Lumbar Transforaminal Steroids / Root Injection
Performed by Dr. Dima Rozen and his esteemed associates, this procedure involves the injection of a long acting steroid into the opening at the side of the spine where a nerve roots exits – the foreman. This steroid reduces the swelling and inflammation of the spinal nerve roots and other tissues surrounding the spinal nerve root resulting in a reduction of pain, numbness and tingling caused by such inflammation and swelling.
This treatment may be chosen when a patient has pain that radiates down the a leg which is often related to compression or inflammation of a spinal nerve root.
No general anesthesia is required for this treatment only a local anesthetic to the area to be treated. Once the area is numbed, a needle is inserted to the epidural space where the inflammation is located. Once needle placement is confirmed, the anti-inflammation steroid is injected to the cervical epidural space where it can work to reduce the inflammation.
Duration of the treatment can last for several weeks to several months.
Radio Frequency Ablation
Performed by Dr. Dima Rozen and his esteemed associates, this procedure is minimally invasive. The treatment delivers an electrical current to the targeted nerves that disrupt the nerve’s ability to send pain signals.
This treatment is often used to treat osteoarthritis and Spinal stenosis, or from a trauma to the back, such as a car accident.
No general anesthesia is required for this procedure only a local anesthetic to the area to be treated. The physician will use live fluoroscopic guidance to direct a special (radiofrequency) needle alongside the medial or lateral branch nerves. A small amount of electrical current is carefully passed through the cannulae to assure it is next to the target nerve and a safe distance from other nerves. This current should briefly recreate the usual pain and cause a muscle twitch in the neck or back. The targeted nerves will then be numbed with a local anesthetic to minimize pain.
The procedure usually take 15-30 minutes to perform and treatment may last for several months to years. The goal is to reduce the patient’s pain so that they can resume normal activities.
Steroid Injections for Knees | Hips | Shoulders
Performed by Dr. Dima Rozen and his esteemed associates, this procedure is a non-invasive procedure that can help relieve pain in the knees, hips and shoulders and can aid in decreasing inflammation and reducing the activity of the immune system.
This treatment may be chosen to treat conditions such as rheumatoid arthritis, gout, or other inflammatory diseases as well as inflamed bursae, or around tendons near the shoulder, elbow, hip, knee, hand or wrist.
No general anesthesia is required for this treatment only a local anesthetic to the area to be treated. To confirm the diagnosis, joint fluid may be removed for testing. Local anesthetic is applied to the area where the needle will be inserted (an ultrasound may be used). If the affected joint or bursa contains excess fluid, the doctor may draw out this fluid with a needle and syringe. Next, the physician will inject a small amount of cortisone into the targeted area which may be mixed with an anesthetic, such as lidocaine or bupivacaine. The injection area is then cleaned and bandaged.
The procedure is usually 5-10 minutes long and pain relief may last for several days or up to years. The goal is to reduce the patient’s pain so that they can resume normal activities.
Sacroiliac Joint Steroid Injections
Performed by Dr. Dima Rozen and his esteemed associates, this procedure involves injecting a mixture of steroids and anesthetic directly into the sacroiliac joint which is located at the bottom of the spine between the sacrum and either of the illium. The ilium provides a joint for the femur and joins with the sacrum at the sacroiliac joint.
This treatment may be chosen to address symptoms of sacroiliac joint problems such as pain around the hip including lower back pain, hip pain and groin pain, and arthritis in the sacroiliac joint. Often times, these symptoms often become worse during physical activity and also due to prolonged sitting or standing for several hours.
No general anesthesia is required for this treatment, only a local anesthetic to the area to be treated.
Once the area is numbed, fluoroscopic guidance is used to open the inferior aspect of the sacroiliac joint. A needle is guided into the joint space and placement confirmed with the injection of contrast. Once needle placement is acceptable a mixture of local anesthetic and steroid is injected directly to the sacroiliac joint.
The procedure lasts 15 minutes and duration of the treatment can vary but typically lasts up to 3-6 months.