RMI provides a range of neuro-interventional procedures to diagnose and treat spine disorders, such as osteoporosis, tumors, compression fractures, infections, or chronic back pain.

Diagnostic procedures:

Myelography with Post-Myelographic CT—Uses an injection of contrast material to enable doctors to view the spine, looking for signs of disease or injury to spinal cord.

Spinal Biopsy—An image guided procedure that uses a needle to extract a small amount of tissue to test for cancer in the spinal column.

Discography with Manometry—Uses injected contrast material, a CT scanner, and a small probe to study the condition of the discs between the vertebrae (bones that make up the spine).

Disc Aspiration Biopsy—Uses X-rays to guide a needle that extracts a small amount of tissue from one or more discs to test for possible infection.

Spinal and pain management procedures:

Epidural Steroid Injections—Uses X-rays to guide the injection of a steroid medication to relieve pain from inflamed nerves in the spine.

Nerve or Facet Blocks—X-ray guided injection of a steroid medication to relieve pain originating in or transmitted through spinal nerves or joints.

Vertebroplasty—Injection, under X-ray guidance, of a special cement into an area of the spine to repair small fractures or cavities in bones, caused by injury or disorders such as osteoporosis.

Sacroiliac Joint Injections—X-ray-guided injection of a steroid medication to relieve pain in or around the sacroiliac region, where the joint connecting the spine and pelvis is located.

Vascular access

Some patients have conditions that require frequent access to a blood vessel. This can include those who receive intravenous medication or nutrition, chemotherapy for cancer, or dialysis for kidney disorders. Other patients may have conditions that require frequent blood transfusions.

To avoid damage to blood vessels from repeated punctures by medical needles, vascular access devices, called catheters, lines, or ports, can be connected to a blood vessel. Medical needles or tubes from treatment devices can then be inserted into the vascular access device instead of directly into the blood vessel, keeping the blood vessel tissue healthy.

Vascular access devices may be installed for short term, long term, or permanent use, depending on the purpose for which they are needed. Some devices are implanted entirely under the skin, while others have an external access point.

Procedures include:

PICC Lines—Catheters for temporary but long-term use (several weeks to several months).

Chest Ports and Arm Ports—Port catheters implanted under the skin for very long term or permanent use.

Permacaths—Long-term catheters tunneled under the skin for dialysis patients.

Hickman Catheters—Long-term catheters for chemotherapy or for intravenous medication or nutrition.

Vascular Interventions:

Vascular interventions are image-guided treatments for issues directly related to blood vessels themselves. The procedures fall into three main categories:

Vascular Ablation—Selective removal of blood vessels that are diseased.

Vascular Embolization—Sealing off a blood vessel to treat conditions such as internal bleeding.

Vascular Interruption—Partially restricting passage through a blood vessel, such as installing a filter that prevents blood clots from reaching the heart or lungs.

Vascular interventions RMI perform:

Gonadal Vein Embolization—Embolization of abnormally enlarged veins in the scrotum that are causing discomfort or fertility issues.

IVC Filter Placement and Retrieval—Filter placements in the inferior vena cava, a large vein that carries blood back to the heart from the lower part of the body, to prevent blood clots from reaching the lungs.

Biopsies

For patients with suspected cancer, image guided biopsies make the process of extracting tissue for further examination easier for the patient. In most cases, this can eliminate the need for a major surgery or a hospital stay. RMI’s interventional specialists are experienced in image-guided abdominal, breast, and thyroid biopsies, among others.

Drainage

Excess fluid accumulations in the body are sometimes symptoms of cancer, infections, heart disease, liver or kidney disorders, or other conditions. Doctors sometimes study fluid from these accumulations to diagnose disease. Drainage may also be a part of the ongoing treatment program for patients with cancer or other conditions.

Image-guided drainage procedures use medical imaging methods to guide insertion of a drainage needle to the site of the fluid accumulation. For patients requiring longer-term or frequent drainage, a drainage tube or port may be installed. These ports may also be used for delivery of drugs that treat certain types of cancer.

RMI’s interventional specialists perform the following procedures:

Paracentesis—Port installation in and/or drainage of the abdominal cavity.

Thoracentesis—Port installation in and/or drainage of the chest cavity.

Abscess Drainage—Drainage of infected accumulations of fluid in the body. This procedure often includes installing a drainage tube.

When an accident or injury results in a small foreign object becoming embedded in soft tissues of the body, such as a fragment of metal or glass in the arm, leg, or foot, it can sometimes be difficult for a doctor to find the object. Attempts to find an embedded object through surgical probing can be time-consuming and stressful for patients.

Medical imaging methods, especially ultrasound, can often make the process of finding a foreign object and identifying a safe extraction path much easier, enabling a radiologist in an outpatient setting to remove an object through a small incision.

If you experience an injury involving a small, embedded foreign object, your doctor may be able to make the removal process faster and easier by consulting first with an RMI radiologist before any surgery is attempted.

Nuclear imaging and treatment procedures can be helpful in planning treatment for certain types of cancer, or for delivering radiation treatments for thyroid cancer or enlarged thyroid disorders. Two procedures in this category that are available at RMI include sentinel node mapping and Iodine-131 therapy.

Sentinel Node Mapping.

For many types of cancer, a critical next step after diagnosis is to identify the stage of the cancer—determining whether it has spread and, if so, where—so that an appropriate treatment can be planned.

Since many types of cancer spread through the lymphatic system, identifying the first lymph node that receives drainage from a tumor—called the sentinel lymph node—is an important part of staging and treatment planning. Once the sentinel lymph node has been identified, it can be removed along with nearby lymph nodes to test for the presence of cancer cells.

In sentinel node mapping, the patient is injected with a small amount of radioactive material that, when absorbed by body tissues, becomes visible to imaging equipment. This makes it possible to observe the process of drainage from a tumor into nearby lymph nodes, to identify the sentinel lymph node.

Iodine-131 Therapy

Iodine-131 is a radioactive substance that is used in treating thyroid cancer or enlarged thyroid disorders. If your doctor orders Iodine-131 therapy at RMI, you will be given, under the supervision of a radiologist, a dose of the substance to swallow in capsule or liquid form.

Iodine-131 is absorbed into the bloodstream and taken up by the thyroid, where it remains for a period of time, destroying some of the thyroid tissues, including excessive or cancerous cells. The treatment takes effect gradually, over a period of one to three months, with full benefit appearing in three to six months.

Iodine-131 therapy requires detailed preparation and followup procedures. Instructions will be given to you in advance of your appointment.