Mark J. Downey, MD & Alex Cotter, MD
10 Old Montgomery Hwy #200. Homewood, AL 35209
Appointments & Referrals: (205) 271-6511
Dr. Mark Downey uses his background in Physiatry to effectively diagnose and conservatively treat the spectrum of bone, muscle, and nerve-related conditions that affect the spine. Using interventional (injection) treatments under fluoroscopy, Dr. Downey is able to restore maximum function lost through injuries or degenerative changes to the cervical, thoracic, and lumbar spine.
All interventional procedures are now performed easily in our office using our new spinal procedure suite. Anesthesia is provided for comfort and monitored light to moderate sedation.
As a general rule, following injections, Dr. Downey recommends physical therapy as a long term solution to improve posture, core strength, weight loss, and overall functional activities.
At Spine Group Alabama the use of injection therapy accomplishes two very important functions.
THERAPEUTIC FUNCTION: The first purpose of the spinal injection is to provide a therapeutic benefit to the patient, that is, relief of pain symptoms, or relief of the weakness or numbness in the leg or arm caused by a herniated disc.
DIAGNOSTIC FUNCTION: The second function is to reveal important diagnostic information to the spine specialist. For instance, if the injection of medication near the nerve root at a certain level of the spine FAILS TO RELIEVE the pain symptom or the weakness caused by the impinged nerve, the spine surgeon learns something very important. One possibility is that the symptoms are coming from a different disc at a different level. This is key, because without this information, a surgeon could operate and remove disc tissue at a level that appears on an MRI to have a herniation, but in fact that herniation is NOT the cause of the patient’s symptoms.
There are two worst-care scenarios that injection therapy is designed to prevent:
Prevent a person from having a surgery that wasn’t necessary in the first place.
Prevent a surgeon from operating on the wrong disc.
In conclusion, if your spine specialist doesn’t at least consider the role of injection therapy in your assessment and treatment, you may be at risk for one of the two worst-case scenarios.
Risks involved with spinal injections are minimal. Minor superficial infections are reported to occur in approximately 1% of all injections with severe or deep infections occurring in 0.1 to 0.01% of injections. Bleeding is rare, as is nerve damage but either can occur due to direct injury to a blood vessel or nerve. A puncture of the dura during an epidural steroid can occur and is estimated to happen in 1 in 200 procedures. Also, patients who are acutely ill or have an active infection may not be able to have a procedure done.
Important- Patients who are on any blood thinning medications, such as coumadin (warfarin), plavix (clopidogrel), lovenox (heparin) or aspirin may be able to have these procedures but they cannot be done while on these medications. You and your treating physician, as well as your primary care doctor or cardiologist, will help decide whether or not it is safe to come off of your blood thinners to have an injection.