Lumbar puncture

Lumbar puncture involves the removal of a small amount of cerebro-spinal fluid that surrounds the brain and spinal cord. The fluid is tested to detect evidence of infection, multiple sclerosis, metabolic diseases, brain hemorrhage or other neurological conditions. The patient will lie on one side. The back is cleaned and local anaesthetic drug is given. A spinal needle is inserted between the vertebrae into the spinal sac and a small amount of cerebrospinal fluid is collected for testing. Patients are asked to lie flat for few hours to reduce spinal headache.

Lumbar Spinal Injections

Image-guided spinal injection is commonly performed in symptomatic patients to decrease pain severity, confirm the pain generator, and delay or avoid surgery. There are various types of spinal injection techniques to reduce pain.

• Spinal Epidural injection
• Lumbar trans-foraminal injection
• Lumbar facet block
• Sacro – ileac joint injection

A combination of local anaesthetic agent along with steroids is the commonly used drug to reduce the inflammation, in turn, reduce the pain.

Trigeminal nerve blocks for trigeminal neuralgia

This procedure is done as an OPD or day care procedure. Depending on the location of the facial pain, the injection is planned to be given a he particular branch of trigeminal nerve.

First branch (Ophthalmic) – Eye, eyebrow, forehead and frontal portion of the scalp

Second branch (Maxillary) – Upper lip, upper teeth, upper gum, cheek, lower eyelid and side of nose

Third branch (Mandibular) – Lower lip, lower teeth, lower gum and side of the tongue. Also covers a narrow area that extends from the lower jaw in front of the ear to the side of the head

The procedure involves placement of a needle into the foramen where the nerve exits. A small amount of glycerol/alcohol along with local anaesthetic agent is injected into the space around the nerve fibers. This results in chemical lysis of nerve fibres and reduces he pain.