RF neuroablation is a procedure in which, under local anesthesia, an electrode is inserted to apply radiofrequency current to the affected tissue. The tip of the electrode is positioned along the small nerve at the selected location (such as the medial branch of the facet joint or the small nerves of the sacroiliac joint using the Synergy® method). This process generates high temperatures (80–85 °C) around the electrode tip, destroying the targeted nerve and interrupting the pain signal pathway from the joint to the central nervous system.

Pulsed radiofrequency neuromodulation is a procedure in which, under local anesthesia, an electrode is inserted to deliver radiofrequency current to the affected tissue. This procedure differs from RF neuroablation. The term “pulsed” indicates that energy is delivered through the electrode in intervals—intermittently, rather than continuously as in thermal ablation—which allows the temperature to remain lower (42–45 °C) than that reached during RF neuroablation. By applying pulsed radiofrequency neuromodulation to the nerve, we block the transmission of pain signals.

Epidural steroid injection is a procedure in which a corticosteroid and local anesthetic are administered into the epidural space—most commonly after diagnosing radicular pain (such as a herniated disc or spinal canal stenosis).

There are three epidural techniques (approaches):

• transforaminal steroid injection (TFESI)
• interlaminar steroid injection (ILESI)
• caudal epidural steroid injection (SCESI)

The goal of the epidural injection is to reduce inflammation and pain, thereby keeping the patient mobile and able to undergo physical therapy. In many cases, this approach can help avoid traditional surgical intervention.

DiscoGel® is a procedure used to treat small to medium-stage disc herniations that are not suitable for traditional surgical treatment. A spinal needle is inserted into the affected disc, and DiscoGel® (gelified ethanol + tungsten) is applied to perform chemonucleolysis.

Ethanol is the active substance, and its gel form prevents leakage outside the disc structure, making the procedure safer. Tungsten acts as a contrast agent that allows visual monitoring of the DiscoGel® distribution.

Disc FX is an innovative procedure that allows a safe and effective approach to the damaged disc without destroying the surrounding tissue. This method is chosen for patients who have not responded to conservative treatment and are not yet ready for major surgery. It is a minimally invasive procedure that does not require inpatient hospitalization.

The procedure consists of 3 phases:

• Scraping – In the first phase, the disc is punctured with a special needle used as a working channel. This needle is used to remove part of the altered inner disc tissue (“scraping”).
• Soldering – Next, a radiofrequency electrode delivers radiofrequency current to “solder” the disc, minimizing the risk of recurrent disc herniation.
• Burning – In the final step, pathologically altered nerves in the posterior part of the disc that cause discogenic low back pain are “burned” using radiofrequency.

Epiduroscopy is a procedure suitable for patients suffering from persistent pain following spinal surgery. Pain in the spinal canal is most often caused by fibrosis–adhesions resulting from previous surgical procedures. During epiduroscopy, an endoscope connected to a special camera is introduced through an opening in the sacrum (hiatus sacralis). This allows us to visualize areas affected by fibrosis in the spinal canal and remove them using laser or radiofrequency.