• Mark J. Downey, MD & Alex Cotter, MD
    10 Old Montgomery Hwy #200. Homewood, AL 35209
    Appointments & Referrals: (205) 271-6511

  • Schedule Now

Pre-Procedure Instructions

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Important Reminders:

**Procedure must be cancelled at least 2 days prior to appointment to avoid $150.00 Fee*

  • Please arrive at least 15 minutes early to your scheduled appointment time.
  • Notify the office if you will be late to your scheduled appointment:(205) 271-6511.
  • For patient’s more than 15 minutes late, an attempt will be made to work you back into the schedule, if time permits. Otherwise, you will be rescheduled to another date.
  • You may not have anything by mouth (food, drink, gum, mint, etc.) after midnight the night before your procedure.
  • If you receive IV sedation, you are not allowed to drive for 24 hours after the procedure. Also, a Driver is required to take you home from the facility.
  • Please bring your insurance or worker’s compensation information to the facility.
  • Please bring a list of all your current medications (or pill bottles if no list available).
  • Blood pressure medication may be taken that morning with a sip of water.
  • If you use an inhaler for asthma, please bring it with you.
  • Insulin SHOULD NOT be taken the morning of the procedure as it can cause an unsafe drop in Blood Sugar while fasting for the procedure.
  • If medication refills are needed, please notify the nurse prior to your procedure.
  • Depending on your assessment by SpineGroup Alabama the day of your procedure, the approach may vary, in order to provide you with the best potential results.


Medications To STOP Before The Procedure:

Due to the potential risk of epidural hematoma (blood clot inside the spinal canal) you are required to discontinue all medications that could inhibit your blood platelets and make you more prone to bruise internally at the site of injection. Specifically our policy is as follows:

*Please check with your primary care physician or cardiologist to obtain medical clearance regarding holding your blood thinner prior to scheduled procedure. Clearance letter should be faxed to 205-271-6513.

  • Aggrenox, Ticlid, Effient, Plavix, Pletal, Ticlid, and Trental must be discontinued for 7 days prior to injection.
  • Regular Aspirin (325mg) and all Aspirin products (Percodan, Excedrin Migraine, Bayer, Alka-Seltzer, Goody’s, Standback, Pepto-Bismol, etc.) must be discontinued for 7 days prior to the injection.
  • Coumadin (Warfarin) must be discontinued for 5 days prior to the injection.
  • Baby Aspirin (81) must be discontinued for 5 days prior to the injection.
  • Xarelto must be discontinued 2 days prior to the injection.
  • Anti-inflammatories (arthritis medications) must be discontinued for 2 days prior to the procedure including: Naproxen (Naprosyn, Naprelen), Ibuprofen (Motrin, Advil, Vifoprofen), Meloxicam (Mobic), Oxaprozin (Daypro), Indomethacin (Indocin), Etodolac (Lodine), Nabumatone (Relafen). *Celebrex (Celecoxib) does not have to be held days prior to procedure*
  • Please discontinue Multi-Vitamins, Vitamin E and Fish Oil for 2 days prior to the injection.


Need an Appointment?

Spine Group Alabama specializes in the treatment of back pain, neck pain, herniated discs, and all types of ligament strain related to the neck and low back. Spine Group Alabama is referred  back and neck pain patients from across Alabama, including Birmingham, Tuscaloosa, Auburn, Huntsville and Montgomery.

Office Hours:
Monday - Thursday: 8am - 4:30pm
Friday: 8am - 2:30pm
Saturday/Sunday: Closed
(205) 271-6511

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