When you and your surgeon meet to discuss interventional spine procedures the risks and benefits will be reviewed and any questions you have will be answered. Although in our experience risks of a procedure are extremely small, the medical literature document the possibility of bleeding, infection, allergic reactions, temporary increase in pain, or possible nerve injury. Although we have not seen these occur, there are always risks.

You are required to have a pre-procedure interview with our nurse to provide you with information regarding your procedure, answer questions, obtain your medical history, and get a current medication list. The nurse will contact you via phone and it is very important that you return any missed call as soon as possible.

• Let us know if you have bleeding disorders, or if you are using blood thinners like aspirin, Coumadin, Plavix, NSAIDs (such as Ibuprofen, naproxen, diclofenac, Advil, Motrin, Aleve)
• If you are taking a blood thinner, please call your primary care physician or cardiologist and ask if it is safe to stop the medication. They will instruct you on how to stop it when it is time for your injection (as they could affect blood clotting and interfere with the procedure). This will reduce the possibility of bleeding complications.
• Please review all of your medications with us prior to your procedure. Please notify our staff about any medication changes.
• Please let us know if you have had fevers, antibiotic treatment, any illnesses, or hospitalization within the last 4 weeks. You must be healthy on the day of the procedure.
• Please inform our office is there is any chance that you are:
• Pregnant or chance of being pregnant
• Allergic to anesthetic, steroid, radiologic dye, shellfish, latex or medicines

• If you have diabetes, your blood sugar numbers may increase. Your primary care physician or our staff will guide you regarding management.
• Continue to take all medications, ESPECIALLY BLOOD PRESSURE MEDICATIONS. Please note: your blood sugar and blood pressure will need to be within a safe range on the day of the procedure.
• Please arrive 15 minutes before your scheduled appointment time.
• Avoid eating a heavy meal 3 hours prior to procedure. Clear liquids allowed up to 1 hour before procedure.

• After checking in at NWSC the nurse will take you to one of our private pre-procedure rooms
• Your vital signs (blood pressure, pulse, and temperature) will be evaluated for the procedure
• Your surgeon will meet with you to review the procedure one last time.

          Your driver is welcome to wait in our lobby or in the pre-procedure room.

• The procedure will take approximately 10 to 30 minutes during which you will be lying face down
• Your injection site will be cleansed and the area covered with a sterile drape.
• Medication is then given to numb the skin near the injection site to ensure you are comfortable.
• Fluoroscopy (x-ray imaging) is used to guide the procedure. Contrast “dye” may be injected to help confirm the target location for the procedure.
• The doctor then places the needles necessary for the procedure and the medication is injected.
• A bandage will be placed over the injection site.

• Pain relief may begin immediately after the medication has been injected. You may experience a brief recurrence of your prior pain until the anti-inflammatory medication takes effect.
• You will be monitored for about 10-15 minutes following the procedure. During this time a nurse will check your blood pressure and pulse to assure that you are feeling well.
• The nurse will review your discharge instructions with you.
• Your surgeon will review the pain scale form that is to be completed before your next appointment and will discharge you.
• Please arrange for a responsible adult to drive you home.

• You may eat your normal diet.
• You may have some discomfort at the injection sites.
• You do not need to stay in bed when you get home. In fact, it is best to walk around.
• Patients can go back to usual activities after the procedure. “Usual” activity means the activities that you were comfortable with immediately prior to having the injection.
• You will be given a pain scale form. Please pay close attention to the degree and location of any pain relief that you experience as you will be expected to bring this documentation with you to your next appointment.
• You may take a shower. Do not take a bath or sit in a hot tub for 24 hours.
• The day after your injection, you can remove the Band-Aids and wash with soap and water.
• If you are taking a blood thinner like aspirin, Plavix, Coumadin, NSAIDs, among others, you may restart it as instructed by your surgeon or primary care physician.

If you develop fever, chills, severe pain, redness or swelling around the injection site or if you have new symptoms, please call Northwest Spine Center directly at 509-834-7050.