FDAcompliant

2040 Short Avenue • Odessa, Florida 33556727-372-9922 • www.Trinity-Spine.com

Victor M. Hayes, MDis a board-certified spine surgeon and is dual fellowship-trained in both endoscopic spinal surgery and reconstructive spinal surgery.

Dr. Hayes received his medical degree from Cornell University Medical College and completed his internship and residency at Long Island Jewish Medical Center, NYC.

Farhan N. Siddiqi, MD Assistant Professor,

University of South Floridais a board-certified spine surgeon and is dual fellowship-trained in both endoscopic spinal surgery and reconstructive spinal surgery.

Dr. Siddiqi received his medical degree from Cornell University Medical College and completed his fellowship training by Dr. Paul McAfee, Professor, Johns Hopkins University.

Dr. K. Riz Saldin, M.D. Interventional Pain Medicine

Board Certified in Interventional Pain MedicineACGME Accredited, Anesthesia-based Fellowship in Pain MedicineBoard Certified in NeurologyFellowship in Neuroimaging

Dr. Riz Saldin joined Trinity Spine in August of 2014 as an Interventionalist interested in offering a unique and conservative philosophy to pain management.

Trinity Spine Center

Trinity Spine Center“Where Surgery is the Last Option”

IN–OFFICE SURGICAL PROCEDURES

Thank You for Choosing Trinity Spine Center for your Spine Care. At Trinity Spine Center, we feel it is important to be an active participant in your own care. Knowing what to expect will help reduce your anxiety, make your time here more pleasant, and can even help speed your recovery.

Using This BookletThe content of this booklet is specific to your upcoming procedure. This information reflects the most current and accurate information that applies to the general population, and is not intended to be a substitute for the information your physician provides you. Because every patient is unique, your experience may be somewhat different so we encourage you to discuss your expectations and any specific questions with your physician or nurse.

In-Office Procedures Performed at Trinity Spine Center:

• Transforaminal Epidural Steroid Injection (TFESI)

• Facet Block• Radio-frequency Nerve Ablation

(RFA)

Scheduling of your Procedure:Your doctor will establish a plan of care to best address your spinal needs. If your plan involves a procedure at the Trinity Spine Center, please follow the procedure instructions as described below to ensure you are able to receive your procedure on the scheduled day and avoid any delays.

• You will receive a phone call 1 week prior to your procedure confirming that you still need this procedure.

• You will receive a second phone call 2 days prior to your procedure regarding your appointment time.

• TEN (10) DAYS BEFORE THE PROCEDURE YOU MUST STOP THE FOLLOWING MEDICATIONS:

• ONE WEEK BEFORE THE PROCEDURE YOU MUST STOP THE FOLLOWING MEDICATIONS:

COMMONLY ASKED QUESTIONS:

• Will Radiofrequency nerve ablation(RFA) help me?

Nerve ablation is most commonly offered to patients with neck or back pain from facet joint problems like arthritis or injury. In order to be a candidate for nerve ablation, you must have responded favorably to diagnostic or trial injections.

• How long will the procedure take? Typically an RFA can take anywhere

from 20 minutes to an hour, depending on the areas being treated.

• Will the procedure hurt? Layers of muscle and soft tissues

protect nerves. The procedure involves inserting an introducer needle or needles through the skin and those layers of muscle and soft tissues, so there is some pain involved. However, we numb the skin and deeper tissues with a local anesthetic using a very thin needle before inserting the introducer or needles.

• What should I expect after the procedure?

Initially you will have muscle soreness following the procedure than may last up to a week. Using ice packs over the area can assist in reducing your discomfort.

Aggrenox TiclidPletal Herbal Vitamins

Trental Vitamin EPersantine Multivitamins/ Fish OIl

Plavix XareltoEffient Eliquis

Coumadin Aspirin and Aspirin Products

PradaxaBlood thinners/NSAIDs including but not limited to Ibuprofen, Celebrex,

Mobic, Meloxicam, Naproxen.

Please note, these procedures cannot be performed if you have an active infection, flu, cold, fever, very high blood pressure or if you are on blood thinners. Please make your doctor aware of any of these conditions. This is for your safety!!

94% of our patients get better without surgery. www.TrinityStemCellInstitute.com

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• If you are on Plavix, Effient, Coumadin, Pradaxa, Xarelto, or Eliquis, we must have your primary care doctor or cardiologist’s written approval to stop the medication.

• You may continue to take the following medications without interruption:

o Blood Pressure medication o Thyroid o Diabetes o Cholesterol o Pain medications• No solid foods or fluids after

midnight prior to the procedure unless directed otherwise. You may take your medication with a small amount of water. Diabetics should not take their medication for diabetes until after the procedure is complete. Please check your blood sugar at home before arriving for your procedure.

Day of your Procedure:Please arrive at least 15 minutes prior to your appointment with a friend or family member who is able to drive you home afterwards. You will be checked in and when appropriate, your nurse will escort you to the procedure room. Here you will be asked pertinent questions regarding the procedure you are having done. Once the procedure is finished, you will be taken to the recovery room where you will stay until ready for discharge. Please follow these recommendations after your procedure to assist in feeling better and regaining

your normal lifestyle.• Avoid Bending, Lifting, and

Twisting. • Mobility is encouraged. Be

sure to get up and walk as you feel comfortable and establish an appropriate cardiovascular workout routine in the upcoming future following your procedure.

• If you have been provided with a back brace, be sure to wear it when not in bed.

• Do not cross legs. • If prescribed, continue or begin

Physical Therapy to strengthen your back and prevent further injury or irritation to your spine.

The Wellness Center:Conveniently located within the Trinity Spine Center. Here you will be seen by a Doctor of Chiropractic Care or Doctor of Physical Therapy as well as State Licensed Physical Therapy Assistants who can guide you in:

• Stabilizing your cervical, thoracic, and lumbar spine.

• Managing your pain and learning how to prevent additional pain or joint problems.

• Using pain relieving modalities to help you feel better and be more active.

• Improving your functional mobility to help you return to your normal lifestyle.

We also have 2 state of the art Decompression tables for reducing sciatica and other radicular symptoms in the legs and arms.

Please call 727-807-3101 to make an appointment.

• What are the risks associated with a facet block?

As is typical of most procedures, there is a slight risk of bleeding, infection, nerve injury, or allergic reaction to the medication associated with this procedure.

• Is the procedure painful? Aside from the chance of localized

pain at your injection site, the procedure is not known to be very painful. The majority of patients report stinging or burning of the numbing medication as the most uncomfortable part of the procedure, however each person’s response is different.

• What are my restrictions after the procedure?

While you are encouraged to move around and attend to your usual activities, we advise

avoiding strenuous activities for at least 24 hours following your procedure. You may not drive for the remainder of the day after your procedure and should avoid any form of heat over the injection site for 24 hours after the procedure.

Radiofrequency Nerve Ablation (RFA):

Radiofrequency nerve ablation is a procedure using electrical current produced by a radio wave that heats a small area of nerve tissue, therefore reducing that nerves ability to transmit pain signals to the brain. This procedure is typically used to help patients who have chronic low back and neck pain achieve pain relief.

www.Trinity-Spine.com Ask us about our Stem Cell Program.

Transforaminal Epidural Steroid Injection (TFESI):A transforaminal steroid injection is an injection of local anesthetic (numbing agent) and steroid medication into the epidural space to help reduce local inflammation contributing to our back or neck pain. Nerves travel through the epidural space to the back and into the legs. Inflammation of these nerve roots may cause pain in the back and legs due to irritation from a damaged disc or bony structure contacting the nerve. Epidural steroid injections are meant to provide pain relief by reducing the inflammation of the nerve roots as they exit the spine. An epidural steroid injection will NOT correct the pre-existing medical problem; however it may improve the level of pain and help to accurately diagnose the cause of the problem. It is common for patients to require more than 1 injection to achieve long term benefits of their pain.

COMMONLY ASKED QUESTIONS:

• Does it hurt? While it is not uncommon to have

mild to moderate discomfort during the injection, every effort is taken to make you as comfortable as possible. During the injection you will receive a local numbing agent that helps to dull the discomfort associated with the injection itself.

• How long will the procedure take? The procedure can take anywhere

from 15-30 minutes.

• How long will it take for the medication to work?

You may experience temporary immediate relief after the procedure that could last up to several hours. Once the numbing agent wears off, your pain may return. This does not mean that the steroid did not help. The steroid medication typically takes two or three days to begin having an effect in most people. In rare cases, your pain may increase for a few days before improving. Some ingredients may take up to a week to start taking effect.

• Are there any restrictions after the procedure?

You may not drive for the remainder of the day after your procedure. A responsible adult

(over 18 years of age) must be present to drive you home or to go with you in a taxi. The procedure will be cancelled if you do not have a responsible adult with you! Also, for the remainder of the day of your injection, you may not take a tub bath, use a hot tub, or go swimming. Please also avoid placing heat over the injected area.

• How many injections can I get? Injections are usually limited to

just a few a year because there is a slight chance these drugs might weaken your spinal bones and nearby muscles. This is not caused by the needle, but it is a possible side effect of steroids. The risk of these side effects increase with the number of steroid injections you receive.

• When should I call Trinity Spine Center?

You do not need to contact us regarding your procedure unless you experience severe pain, new pain or numbness and/or weakness of your arms or legs, a temperature of 100.5 or greater, a severe headache that does not go away with your usual headache medication, or signs of infection in the area of the injection (redness, swelling, heat, discharge). If you experience any of these symptoms, please do not hesitate to contact us at 727-372-9922.

Facet Block: Facets are small joints along each segment of the spine that provide stability and assist in guiding each spinal levels motion. These joints can become painful due to mechanical stress to the spine, back injuries, or arthritis. During a facet block, a small amount of local anesthetic (numbing agent) and/or steroid medication are injected into the joint to help block pain. The two main goals of a facet block are to assist in accurately diagnosing the cause and exact location of pain and to provide pain relief.

COMMONLY ASKED QUESTIONS:

• Who is a candidate for a facet block?

Patients who have pain in their low back predominantly from arthritic changes or mechanical low back pain are typically indicated for a facet block.

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