Kraus Back and Neck Institute in Houston, TX

Relief from Lower Back and Neck Pain

surgery optionsavoid surgery
      At the Kraus Back and Neck Institute (KBNI), we specialize
                 in non-surgical as well as surgical treatments
                                of Back and Neck  Pain
     Conservative to Surgical Options: MINIMALLY INVASIVE SPINE SUGERY 
 "Applying Science to the Art of Medicine"                                                  
                 Dr. Kraus is available for Neurosurgery consultation (surgical and non-surgical) in Houston.
                      Offices:  1) West Houston Medical Center
                                    2) Memorial Hermann Memorial City Hospital
                                    3) Katy
           FILM REVIEW:  send an e mail                                       
      To arrange  an appointment, call 281-870-9292,  visit
or   send an e mail
              For national and international patients, we can help with  travel arrangements
                                         top doctors houston texas 2007 top docs united states neurosurgery spine   top doctors houston texas 2008 top docs united states neurosurgery spine  top doctors houston texas 2009 top docs united states neurosurgery spine   best doctors in america, united states neurosurgery spine
                                            Dr. Kraus is honored to be listed in
                                            "Best Doctors in America" (2001-2008) and
                                             "Top Doctors of Houston, Texas" (2007, 2008, 2009)     

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Low Back Pain, can be very debilitating.  The effects of Low Back Pain in the USA are staggering!!

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   last updated
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Spinal Injections

Transforaminal Epidural Steroid Injections

The nerve roots in the spinal canal leave the spine through openings called neural foramen.  These are openings which are formed by the joint in the spine which interconnects the vertebral level from below, with the vertebral level from above.  This joint is also known as a facet.  Normally, the foramina are wide open, leaving a wide space for the nerve to travel.  When arthritis sets in, or when there is a herniated disc in the foramen, the nerve can become pinched, leading to pain in the leg or arm.  By selectively placing a needle into the neural foramen, a combination of steroid medication and local anesthetic can be placed around the nerve.  The anesthetic (such as lidocaine or marcaine) will have the effect of immediately relieving some of the pain, while the steroid will have a longer lasting effect.  This technique allows the physician to selectively target a nerve, which may have not only a therapeutic effect of helping pain, but a diagnostic effect as well, in as far as it helps the physician and patient to determine whether the target root was causing the patients pain.


Translaminar Epidural Steroid Injections

The spinal canal, in which the nerves lie (in the lumbar spine), and in which the spinal cord lies (in the cervical spine), is covered by a bone, or roof of the spinal canal, known as the lamina.  There is a space between the lamina of two adjacent vertebral levels.  This space is the interlaminar space, and it is in this space that a translaminar epidural steroid injection will deposit steroid and topical anesthetic within the spinal canal.  A needle is placed into this space, through a ligament called the ligamentum flavum, and the steroid and local anesthetic are instilled.  In contrast to a transforaminal injection of epidural steroid, more medication can be given here, and it will disperse out over many nerve roots, whereas a transforaminal injection is more selective in affecting the root it is targeted at.  The translaminar epidural steroid may have the ability to disperse medication over a broader region, whereas the transforaminal epidural steroid injection will allow the physician to selectively target a nerve root, and can help with diagnosing the source of pain.

Caudal Epidural Steroid Injections

Facet Block Injections

Facet Joint Injections

Sacroiliac Joint Injections

The sacroiliac joint is located at the union of the surfaces of the sacrum and the iliac bones (the pelvis and the spine).  It is held together by ligaments.  This joint is subject to the strains of arthritis, as it bears the weight of the upright body.  Because the ligaments and the joint receive nerve supply from the L3 to the S3 nerve roots, the nature of sacroiliac pain is often vague and poorly defined.  An injection into the joint is generally done by the use of a spinal needle (generally 22 guage or 24 gauge).  The needle is placed, often under x-ray guidance, into the joint.  Then, a combination of steroid and anesthetic is injected into the joint.





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