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The Disc FX System is an innovative, minimal access spine system to efficiently access the damaged disc without injury to surrounding disc anatomy. Disc FX permits multiple treatment options compared to other ‘single treatment’ devices in the marketplace. In addition to manual decompression, Disc FX can help to clean the disc and seal tears in the annulus. Disc FX provides an option for those people who have failed conservative care, and are not yet ready for major surgery. This is a same day procedure with only a small bandage and no large incisions. Following manual removal of the offending herniation, the Trigger- Flex device is activated to help clean the disc and seal the tears in the annulus. As a result, pressure in the disc is reduced, which eases symptoms.
Patients with symptomatic contained disc herniations that have not responded to conservative treatment, may experience relief from Disc FX. Typical signs of a contained lumbar disc herniation is lower back with or without radiation symptoms of numbness and tingling down the legs.
The Disc Fx system require the patient to lie prone on their stomach. Minimal anesthesia with IV sedation may be necessary. A needle is inserted into the skin near the affected disc level, followed by an incision through which a slightly (larger than the needle) hollow tube is placed. Graspers are inserted through the tube and used to manually remove and decompress the interior of the disc which is herniated and and causing pressure against the nerve. The patented trigger-Flex can then be used to help clean the disc and seal the tears in the annulus. This will intern reduce the overall pressure inside of the disc which eases pain symptoms. At the conclusion of the procedure, once the annulus is sealed, the tube is removed and a small bandage is applied.
Patients are required to remain at the facility for 30 minutes to an hour for recovery. Upon release, patients are driven home by the surgery center. Patient should rest for one to three days with limited standing and walking. There may be soreness or bruising at the site of the procedure for up to a week. In most cases, symptoms caused by the disc herniation are gone or decreased within two weeks. After one week of the procedure, patient should return back to physical therapy, which is important for full recovery. Patient can return to work after 3-5 days depending upon the patient’s recovery.
As with any minimally invasive disc treatments, side effects of the Disc FX are relatively rare. This is very safe procedure because patients are monitored with live nerve monitoring to ensure the safety of the patient and prevent any complications.
Epidural Steroid Injection is the placement of cortisone, a powerful anti-inflammatory agent mixed with preservative free lidocaine an anesthetic into the epidural space. It has been used for over 40 years as treatment for back pain. It can be placed in centrally or antero- laterally based upon the location of the disc herniation on MRI review. The main goal of the epidural injection is to shrink the swelling in the bulging or herniated discs and decrease any inflammation that surrounds the spinal nerves.
Epidural space is a potential space within the spinal canal. It surrounds the outermost covering of the spinal cord (dura mater). It contains nerve roots, blood vessels & fatty tissue.
Epidural Steroid Injections help patients with disc herniations, spinal stenosis and sciatica which is a burning type pain into the extremities. It is considered to be an effective means for the nonsurgical treatment of spinal pain syndromes.
The actual injection takes only a few minutes. The procedure is done anesthesia or under local anesthesia to minimize discomfort.
It is done with the patient lying on the stomach with fluoroscopic (x-ray) guidance. The skin is cleansed with anti-septic solution and then the injection is carried out based upon the exact location of the spinal nerves affected. After the injection, you are taken to a recovery area to rest.
Epidural injections are generally safe procedures. Any interventional procedure within the spine may have very minimal risk of infection, bleeding, spinal headache and injury to blood vessels or nerves. The complications are prevented by the use of anti septic techniques and x-ray and dye to visualize exact needle placement.
Epidural injections are generally safe procedures. Immediately after the injection, you may feel that your pain may be gone or quite less. This is due to the local anesthetic injected. This will last for a few hours. The steroid medication will take about 3-5 days to work and cause overall anti-inflammatory effect and pain reduction. The steroid will offer relief for several months duration.
A facet joint injection is an injection of an anesthetic with a long lasting steroid (“cortisone”) into the facet joints. Facet joints are located in the back and neck at each vertebral level. They are surrounded by a capsule that has nerves both inside the capsule of the joint and outside which can cause pain.
The steroid injected reduces the inflammation in the joint space. This can reduce pain, and other symptoms caused by inflammation such as nerve irritation.
The actual injection takes only a few minutes. The procedure is done under local anesthesia to minimize discomfort.
It is done with the patient lying on the stomach with fluoroscopic (x-ray) guidance. The skin is cleansed with anti-septic solution and then the injection is carried out. After the injection, you are taken to a recovery area to rest.
It is generally a safe procedure. But as with any interventional procedure, it carries a small risk of potential complications such as bleeding, infection, leaking spinal fluid & injury to blood vessels or nerves in and around the spine.
Immediately after the injection, you may feel that your pain may be gone or quite less. This is due to the local anesthetic injected. This will last for a few hours. The steroid medication will take about 3-5 days to work and cause overall anti-inflammatory effect and pain reduction. The steroid will offer relief for several months duration.
Radiofrequency Lesioning is a procedure using electrical impulses to interrupt conduction on a semi-permanent basis. The radio frequency waves are used to produce heat on specifically identified nerves. The nerves to be ablated are identified through injections of local anesthesia prior to the procedure during medial branch blocks. By generating heat around the nerve, its ability to transmit pain signals to the brain is destroyed, thus ablating the nerve.
Patients who have responded to previous facet nerve blocks or medial branch blocks with greater than 80% relief in symptoms can benefit from this procedure. The blocks are used in effort to identify the source of the pain. The RFA procedure helps to permanently reduce the pain in the back or neck. The procedure takes about 40-60 minutes. Pain relief can last anywhere from six months to two years.
The patient is given mild anesthesia to minimize discomfort. After numbing the skin with generous amount of local anesthetic, a special needle is advanced near the pain causing nerve under X- ray guidance. The pain causing nerve is tested to confirm the correct placement of the needle before the nerve is numbed with lidocaine solution followed by the Radiofrequency Ablation.
It is generally a safe procedure. But as with any interventional procedure, it carries a small risk of potential complications such as bleeding, infection, leaking spinal fluid & injury to blood vessels or nerves in and around the spine.
Immediately after the injection, you may feel that your pain may be gone or quite less. This is due to the local anesthetic injected. This will last for a few hours. The heated nerve may cause an initial sensation of burning or numbness as it is dying that may last 3 weeks. The neck and lower back pain should be reduced from 6 months up to 2 years duration. The procedure may be repeated as the nerves grow back and the pain returns around the facet joint.
A sacro-iliac joint injection is an injection of an anesthetic with a long lasting steroid (“cortisone”) in the sacro-iliac joints. Sacro iliac joints are located in the back where the lumbosacral spine joins the pelvis. They are paired (right and left) and are surrounded by a joint capsule like the facet joints.
The steroid injected reduces the inflammation in the joint space. The injection can reduce pain and inflammation from a hypermobile joints.
The actual injection takes only a few minutes. The procedure is done under local anesthesia to minimize discomfort.
It is done with the patient lying on the stomach with fluoroscopic (x-ray) guidance. The skin is cleansed with anti-septic solution and then the injection is carried out. After the injection, you are taken to a recovery area to rest.
It is generally a safe procedure. But as with any interventional procedure, it carries a small risk of potential complications such as bleeding and infection.
Immediately after the injection, you may feel that your pain may be gone or quite less. This is due to the local anesthetic injected. This will last for a few hours. The steroid medication will take about 3-5 days to work and cause overall anti-inflammatory effect and pain reduction. The steroid will offer relief for several months duration.
Discography is a diagnostic procedure, not a treatment. X-ray dye is injected into the spinal discs and then the patient is sent for a CT scan of the spine to evaluate for tears or fissures in the discs. The results of the procedure can be helpful to locate the exact site of pain for both interventional and surgical procedures.
The procedure is done under fluoroscopic (x-ray) guidance. The patient is lying on his stomach. The skin over the injection site is cleansed with an antiseptic solution. The patients are usually given a light sedative after which the needles are positioned.
When a normal healthy disc is injected with dye, there is a sensation of pressure but not pain. When an abnormal disc is injected, there s a feeling of pain. It is important to try to determine whether the pain is the similar “typical pain” or a different pain. When each disc is injected, you will be asked if it is painful, where you feel the pain, and whether it is the same area as your “usual pain”.
Based on your MRI findings, your doctor will determine which discs will be injected and evaluated. In addition, a normal disc is injected to serve as a reference point. The procedure takes about 45 minutes.
A small amount of anesthesia will be given to help alleviate discomfort. The procedure involves inserting a needle through the skin and deeper tissues, so there is some discomfort involved. However, your doctor will numb the skin and deeper tissues with local anesthetic using a very thin needle prior to inserting the needle into the disc. Despite this, the procedure is intended to reproduce your “usual pain”.
It is generally a safe procedure. The most common side effect is temporary discomfort. Sometimes the discogram needle brushes past a nerve root and the nerve root is irritated. This gets better quickly. The other risks are infection, bleeding, and worsening of symptoms. Patients are given antibiotics prior to the procedure and injected within the discs which virtually eliminates all risk for infection.
No, Discography does not treat your condition. It is a diagnostic test that allows your doctor to plan your treatment.
Our pain management doctors provide world-class, utmost professional care and a dynamic, team-oriented approach to offer relief for chronic pain.
Dr. Jignyasa Desai has devoted her life to health care and the improvement of pain conditions.
Mission statement:
iHeal Pain Center is founded by Dr. Jignyasa Desai with a dedication to eliminate pain and optimize health. Through traditional and innovative approaches, the center focuses upon healing of sports injuries and spinal disorders in all patients ranging from the athletic to the elderly. Dr. Desai methodology involves a holistic approach encompassing therapy, nutrition, and non-surgical techniques with the ultimate goal of improving daily function and lifestyle.
Training
College: East Tennessee State University B.S. Biology with honors
Medical School: Lake Erie College of Osteopathic Medicine
Internship: Aria Health System via Philadelphia College of Osteopathic Medicine
Residency: Physical Medicine and Rehabilitation- Stonybrook University
Fellowship training: Pain Medicine- Temple University (ACGME accredited training program)
Board Certifications:
• Physical Medicine and Rehabilitation (AAPMR)
• Pain Medicine (ABA)
Society Memberships:
American Board of Physical Medicine and Rehabilitation (AAPMR)
American Society of Interventional Pain (ASIP)
Society of Interventional Pain (SIS)
American Society of Physicians of India (APPI)
American Society of Osteopathic Physicians (AOA)
State Licenses:
New York and New Jersey
Publications
• Frankenberger V, Desai J. Prosthetic Management of Residual Limb Ulcerations with a Vacuum Assisted Socket Suspension: American Journal of Physical Medicine and Rehabilitation. Volume 87 (3), Page S49, March 2008
• Tang N, Desai J, Stickevers S, Awan G. Hip, Buttock, and low back pain associated with ischiogluteal bursitis a case report: American Journal of Physical Medicine and Rehabilitation. Volume 88, (3) Page S12, March 2009.
• Desai J, Stickevers S. Treatment of post amputation focal dystonia with Botulinum Toxin A: American Journal of Physical Medicine and Rehabilitation. Volume 88, No 3. Page S20, March 2009.
• Desai J, Lai Y. Methylmethacrylate (MMP) hypersensitivity reactions post orthopedic hardware implantation: A case report: American Journal of Physical Medicine and Rehabilitation. Oct 22, 2009.
• Desai, J, Fahmy, M. Herpes Zoster associated with Recurrent Bell’s Palsy: A Case Report: American Journal of Physical Medicine & Rehabilitation: 89(4): S79, April 2010.
• Desai, J, Semel, J. Assessing Fall Data in Rehabilitation Hospitals Leading to Prevention Strategies. American Journal of Physical Medicine & Rehabilitation: 89(4): S83, April 2010.
• Kohane, Dan, Desai, J. Case Report: Brachial Amyotrophic Diplegia (BAD). 2011 (AAP) Association of Academic Physiatrists. Annual Meeting in Phoenix, Arizona, April 12-16, 2011.
• Desai J, Falco F. A case study: Peripheral Nerve Stimulator (PNS) in treatment of intractable migraines. To be submitted for publication 2011
• Vesga R, Falco F, Husain A, Desai J. Chapter 12: Abdominal Pain and Treatment Options. In: Kaye A, editor. Understanding Pain: Taking Control of Your Life. Praeger/ABC-CLIO Press; 2011.
• Falco F, Desai J. Stimulation produced analgesia. In: Manchikanti L, Christo P, Trescot A, Falco F (eds.). Comprehensive Pain Medicine and Interventional Pain Management Board Review. Paducah, KY: ASIPP Publishing; 2011.
• Zhu Z, Falco F, Desai J. Intrathecal drug delivery. In: Manchikanti L, Christo P, Trescot A, Falco F (eds.). Comprehensive Pain Medicine and Interventional Pain Management Board Review. Paducah, KY: ASIPP Publishing; 2011.
• Onyewu C, Desai J, Falco F. EEG, MEG. In: Manchikanti L, Christo P, Trescot A, Falco F (eds.). Comprehensive Pain Medicine and Interventional Pain Management Board Review. Paducah, KY: ASIPP Publishing; 2011.•Desai, J, Sakheim, K. Anti-Depressants in Pain Management. Pain Management Clinical Pocket Guide. Currently in Publishing for spring of 2013.