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Interventional Pain Solutions

Is chronic pain limiting you from living an active, fulfilling life?  At Panorama Orthopedics & Spine Center, we offer advanced, research-based, interventional pain solutions for patients.  

Benefits Include:

  • Cutting-edge techniques supported by clinical studies
  • FDA approved procedures
  • Non-surgical, alternative solutions to medication
  • Unique approach in an orthopedic practice setting

ReActiv8 with Mainstay – Restorative Nerve Stimulation

ReActiv8 is an implantable restorative neuro-stimulation system to treat intractable axial low back pain. It is proved through clinical research that ReActiv8 is the only proven neuro-stimulation system to address mechanical intractable axial low back pain by restoring spinal motor control.

You may be a candidate for ReAciv8 if:

  1. You are suffering from chronic lower back pain that has no definite diagnosis requiring surgery (e.g., fracture or stenosis)
  2. Physical therapy and medications are not working
  3. Pain is more prominent in your lower back than in legs
  4. You haven’t undergone prior lumbar spine surgery

ReActiv8 placement

ReActiv8 system is implanted under your skin in the upper buttock or lower back area using a minimally invasive procedure under deep sedation. The device comprises of an implanted pulse generator and two leads that are positioned to stimulate the nerves that control your multifidus muscle, a deep muscle in your lower back that is the main stabilizer of the spine.

It’s a Patient-controlled therapy

Once you will recover from surgery, the device activation process begins. The physician, using your feedback, will calibrate the system to deliver optimum stimulation. The goal is for the therapy to feel like a comfortable muscle contraction. At home, you will use a wireless remote control to start the therapy sessions, typically twice a day. Over time these therapy sessions will restore the body’s ability to support the spine, improve your function and decrease your pain.

Randomized controlled studies

A worldwide double blinded, randomized, sham-controlled clinical trial of the ReActiv8 system showed durable, statistically significant, and clinically substantial benefits in a large cohort of patients with severe, disabling CLBP.

These Clinical trials of ReActiv8-B revealed that 80% of patients were “definitely satisfied” with the treatment at two years. By this time, 72% of patients have at least decreased their pain by half, and 67% of patients have effectively resolved their chronic low back pain. Also, 60% of the patients previously taking opioids had voluntarily discontinued or reduced their use.

  1. Gilligan C, Volschenk W, Russo M, et al. An implantable restorative-neurostimulator for refractory mechanical chronic low back pain: a randomized sham-controlled clinical trial. Pain 2021; Article in Press. doi: 10.1097/j.pain.0000000000002258
  2. Christopher Gilligan MD, et al. Long-Term Outcomes of Restorative Neurostimulation in Patients with Refractory Chronic Low Back Pain Secondary to Multifidus Dysfunction: Two-Year Results of the ReActiv8-B Pivotal Trial. Neuromodulation: Technology at the Neural Interface.

Sprint - SPR – Peripheral nerve stimulation

If you are suffering from a temporary pain and looking for a non-narcotic, non-surgical alternative for your chronic and acute pain relief, then Sprint Peripheral Nerve Stimulation (PNS) System may be for you. SPR-PNS is a minimally invasive treatment to relieve:

  • Low Back and neck pain
  • Knee pain (Inoperable and Post-Surgical)
  • Shoulder pain (Inoperable and Post-Surgical)
  • Foot and ankle pain (Inoperable and Post-Surgical)
  • Nerve or plexus trauma
  • Post-operative nerve pain
  • Post-amputation pain
  • Post Herniorrhaphy pain
  • Complex Regional Pain Syndrome (CRPS)
  • Post Decompression/transposition surgeries
  • Meralgia Paraesthetica

How it works?

The Sprint-PNS System works by connecting a wearable stimulator to a 0.2mm (about the size of a coarse human hair) wire placed through the skin. The stimulator sends mild electrical pulses through a very small MicroLead, directly to the nerves to stimulate them. This method works to eventually reduce pain signals being sent to the brain from the nerve cells. The level of stimulation is easily controlled with a hand-held remote to comfortably provide pain relief. It can be used for up to 60 days. Ultrasound is used to place the mircrolead near the nerve causing pain, requiring no incisions.

Benefits of Sprint-PNS System

Some of the key benefits of SPR-PNS are:

  • No permanent implants
  • No invasive surgery (no incisions)
  • No tissue destruction
  • No nerve damage
  • No opioid prescription
  • FDA approved

It is clinically proven that the majority of patients experience sustained relief after the MicroLead is removed and the treatment ends.

Stimwave Technologies

If you have chronic pain, Stimwave Technologies’ Freedom Systems, the PNS (Peripheral Nerve Stimulation) and SCS (Spinal Cord Stimulator) products, may help to provide long-lasting pain relief. This treatment option involves implanting a device that sends electrical stimulation to block pain signals at the pain source.  Stimwave is powered wirelessly through HF-EMC technology–without an implanted battery.

How it works?

The Stimwave Technologies’ Freedom Systems uses micro technology, which makes it the smallest pain relief implant in the world. A tiny electrode array and receiver are implanted near a peripheral nerve in your body.  The electrode array and receiver fits through a needle sized incision and is performed as a minimally-invasive, outpatient procedure.

What does the StimWave system offer?

Stimwave Technologies is an FDA approved system for management of chronic intractable pain. It offers:

  • Targeted pain relief below the head (including knee pain, shoulder pain, arm & wrist pain or foot & ankle pain)
  • Minimally-invasive technique
  • No battery implanted inside of your body
  • External power transmitter that eliminates a requirement for sitting while charging
  • Outpatient procedure
  • A non-drug therapy option

mild® Procedure – Minimally Invasive Lumbar Decompression

What is Lumbar Spinal Stenosis (LSS)?

LSS is a condition in which the lower spinal canal narrows and compresses the spinal nerves in the lower back.  This compression often results in pain and mobility issues.  If you:

  1. Feel pain or numbness in your lower back while standing
  2. Experience pain, numbness or tingling in legs or buttocks while walking
  3. Get relief when sitting or leaning forward

You might be suffering from Lumbar Spinal Stenosis (LSS).

Take your next step to mild

If you’re suffering from LSS and alternative treatments such physical therapy, pain medication or chiropractic care are not providing the adequate relief to your pain, then mild may be a treatment option for you. The mild Procedure is performed using a local anesthetic and light sedation, leaving no implants behind.

How it works?

This procedure works by removing excess ligament tissue to restore space in the spinal canal, which is the major root cause of LSS. The procedure typically takes less than an hour and can be performed through a single, tiny incision smaller than the size of a baby aspirin (5.1 mm).

What are the benefits of mild?

  • Increased mobility
  • Outpatient procedure
  • Can be beneficial even if you already had a surgery
  • Compatible for patients with existing risk factors
  • Safety profile equivalent to epidural steroid injection (ESI) but with long-lasting results
  • Does not require general anesthesia, implants, stitches, steroids, or opioids
  • Extremely low complication risk
  • Minimal time for recovery
  • Minimal post-procedure restrictions

Clinical outcomes of mild

A 1-Year Cleveland Clinical Study revealed that after mild treatment, patients were able to increase their average standing time from 8 minutes to 56 minutes and walking distance from 246 feet to 3,956 feet with less pain. A 5-Year Cleveland Clinic Study indicated that mild helped 88% of patients avoid back surgery for at least 5 years while providing lasting relief.

View clinical data: (link to https://www.vertosmed.com/patients/)

Intracept by Relivient – Basivertebral Nerve Ablation

If you are experiencing chronic, axial (midline), non-specific lower back pain for six months or longer and have failed conservative therapies, Intracept basivertebral nerve ablation can help you to reduce your pain. The Intracept by Relivient, is a minimally invasive, outpatient procedure targeted to ablate the Basivertebral Nerve in the vertebral body to significantly improve chronic, axial low back pain. The procedure maintains the normal spine architecture and does not use an implant.

How it works?

In Intracept basivertebral nerve ablation procedure your surgeons uses the radiofrequency energy to ablate, or destroy, the nerve that is transmitting pain signals to your brain. It targets the basivertebral nerve for the relief of chronic vertebrogenic low back pain. Ablating the nerve stops the pain signals, resulting in reduced or eliminated low back pain.

Benefits of Intracept by Relivient

  • Safe and effective treatment for management of axial pain
  • Long-lasting treatment for chronic lower back pain caused by vertebrogenic pain syndrome
  • Provides a treatment option for patients who have not responded to conservative therapy
  • Implant-free and preserves the structure of the spine
  • Minimally invasive, outpatient procedure
  • FDA approved.

Clinical studies

Level 1, randomized, double-blind, sham-controlled clinical trials demonstrate the safety and effectiveness of the Intracept procedure with the procedure leading to statistically significant pain relief and functional improvement.

Another study showed that radiofrequency ablation of the basivertebral nerve is a safe and effective treatment for discogenic chronic low back pain.