Dr. Jay Mergaman
What can I expect after my procedure?
You may feel sore or have an increase in your normal pain for the first 24-28 hours. This is especially evident when the anesthetic wears off. The steroid can take 2-3 days to begin to work. Depending on the type of injection you have had and the location (low back or neck) you may experience some weakness or numbness to the legs or arms for a few hours do to the local anesthetic. This does not always occur. There may be some tenderness around the injection sites for a couple of days following the injection. Use ice for the first 24-48 hours to these sites. Usually 20 minutes on, twenty minutes off.
Can I go to work following my procedure?
You should rest for the remainder of the day following your procedure. You may return to your normal activity level the following day. This includes activities like work, school, and physical therapy. Please remember you may be sore, so light activity would be preferred for the first 24-48 hours after the procedure.
How long does the procedure take?
Most procedures performed take only a few minutes. The rhizotomy takes about 30 minutes, and the discogram takes about 40 minutes. We ask that you allow us about two hours of time for your visit. While it may take less time, we like to assure that we are treating each person as an individual and using the time that is needed to do so. This will include preparation and recovery time as well.
Will the injection hurt?
We offer the comfort of IV sedation for most of the procedures performed here at the center. IV sedation puts patients into an altered state of consciousness through the use of pain relievers and sedatives.
This is not general anesthesia. Conscious sedation keeps patients very comfortable and there may be a brief period of amnesia immediately following the procedure so that you do not remember the actual injection. This lasts only a few minutes.
Sedation is administered by trained and certified anesthesia personnel.
How many injections do I need?
Pain may be relieved after one injection, however it is not uncommon to have some but not complete relief after one injection. If in one or two weeks your pain is not relieved following your first injection, a second and if needed a third injection can be repeated to help relieve the pain. Many times physicians order a series of two or three injections as some feel it will be more beneficial for a greater period of time.
How many injections can I have?
We generally do no more than three steroid injections in a six month period. This does not effect how many levels are done at once. For example, we may do two or three levels in one session. This can be done three times in a six month period.
How long will the medication work?
This does not have a straight forward answer as each patient and the reason for the injection is different. The medications effects and pain relief vary and may last several days to several months. A small percentage of patients get no relief. The goal is to inject medications that promote healing to an injured area. If healing occurs, the relief can be substantial and long lasting.
What can I expect during the procedure?
You will discuss your medical history and medications with a nurse and anesthesia personnel. If you choose to have IV sedation for your procedure, an IV catheter will be inserted either in the pre op area or the procedure room. This is for the IV medication administration which will relax you. We will assist you to an X-Ray table where you are usually lying on your stomach. The staff will help position you as comfortable as possible. This position is optimal for the physician to visualize the spine under X-Ray. The skin is prepped and scrubbed in the area of the spine the physician will be working. This helps assure sterility. If you have chosen to use IV sedation, it will be administered at this time. The physician will then numb the skin and muscle forming a trac to insert the procedure needle. Patients choosing local anesthetic only will feel some burning when the numbing medication is injected. This will last only a few seconds and then go numb. Next, the physician will identify the level and space he is guiding the needle to. The needle will be passed through the numb trac using X-Ray guidance so that the physician may see that advancement and placement of the needle. Depending on the procedure a small amount of contrast dye will be injected to confirm placement. Once proper needle position is confirmed, the medications will be injected. Patients choosing local anesthetic only may feel some pressure during needle placement. They may also feel a flushing feeling during the injection of the contrast and may feel a brief discomfort during the injection of the medication. Patients choosing IV sedation may not experience this as they will still be under the effects of the sedation. The procedure will be complete and we will move you to a bed where you will go to the recovery room for a short time so that we may assess your vital signs, and test your mobility. You will be given a snack and drink at this time. Once you are awake and mobile you will be discharged to go home. Patients that have had sedation must have an adult accompany them. This adult needs to drive you home.