Interventional Spine Center

In recent years there have been major advancements in the study and treatment of painful spine conditions. At OrthoArkansas we are committed to accurately diagnosing and treating these complex disorders. At some point through your evaluation and treatment course, your OrthoArkansas spine specialist may recommend an interventional procedure for either therapeutic treatment of your spinal condition or to assist with diagnosing the precise source of your symptoms. Injection-based treatments are often done in conjunction with other effective treatments such as Physical Therapy, exercise, or medications to help with your rehabilitation.

OrthoArkansas Interventional Spine Center has state-of-the-art fluoroscopy machines available for both diagnostic and therapeutic procedures, and our physicians offer the latest in safe and effective treatments. Our emphasis on outpatient care allows us to offer cost-effective ways to manage painful symptoms of spinal disorders.

We are driven by 3 primary goals:

  • Help patients become more functional
  • Reduce use of medications
  • Prevent surgery

Below, we will discuss what you should expect before, during, and after a typical procedure.
We want the arrangements for your procedure to be as smooth as possible. If you have other questions, please do not hesitate to call OrthoArkansas Surgery Center at 501-604-4151.

Day Of Your Procedure

  • If you are taking any blood-thinning medications such as aspirin, Plavix, Coumadin/warfarin, etc., you should have received instructions about whether or not to continue taking these. If you are unsure or have any questions, please call your scheduler or our nursing staff in advance to clarify.
  • If you are a diabetic AND your planned procedure involves the use of corticosteroid (a.k.a. ‘cortisone’ or simply ‘steroid’), please discuss with the physician who manages your blood sugar medications whether these will need to be changed for a short time after the procedure.
  • Most patients may eat a light breakfast or lunch before your procedure, unless specifically instructed otherwise.
  • Some procedures may be specifically ordered with light sedation. IF this is the case we will have discussed with you that you may not eat or drink after midnight prior to your procedure, other than your usual medications.
  • Make arrangements to spend 2-3 hours at the Interventional Spine Center, including check-in, pre-operative evaluation, the procedure itself, and post-procedure care.
  • Please leave all jewelry, purses, and valuables at home.
  • Wear clean, comfortable clothing and shoes. Clothing must fit loosely over the injection site.
  • Make arrangements for a responsible adult to bring you during your visit, stay on site throughout your time here, and to drive you. Seating is limited in our waiting room; please limit visitors.
  • Be prepared with a list of all current medications, previous surgeries, and any health problems you may have.
  • You may take your routine medications (heart, blood pressure, etc.) with a small sip of water.

During The Procedure

After being checked in and evaluated by the nursing staff, you will be taken back to the procedure room by wheelchair or stretcher. The procedure room staff will help you get positioned on the procedural table; usually you will lie face down with a pillow under your stomach or chest, but some neck procedures require lying on your back.

Once positioned, the injection area will be sterilized with a cold cleaning solution and the fluoroscopy (live X-ray) machine will begin taking pictures of your spine. Fluoroscopy is important to enable the physician to see your spinal structure and ensure accurate needle placement for best results. Your physician will use a small marker to line up the planned approach.

The procedure begins with numbing medicine to deaden the area where the needle will be placed; this feels like a sharp pinch and burn like a bee sting. At this point, we expect you to feel mostly pressure as the needle is advanced to the correct position in or near your spine.

Once the needle’s position has been checked from several angles, contrast dye is injected to verify that medication will flow to the correct area the physician is targeting. At this point, it is common to slightly adjust the needle to ensure an ideal result. Once the final position is verified, the medication will be injected.

During the treatment, your vital signs will be closely monitored by our nursing staff. Since the actual procedure typically only takes about 15 – 20 minutes, you’ll soon be moved to the recovery room. Here, your vital signs will again be monitored for safety before you go. Most patients only stay in recovery a short time.

After Your Procedure

You should receive a post-procedure packet with useful information about what to expectand what to watch out for.

It is quite common to have some increased discomfort following an interventional spine procedure. This is often due to the local anesthetic (numbing medicine) wearing off before the therapeutic medication (often steroid) begins to work.

DO plan to take it easy for the remainder of the day (unless instructed otherwise for diagnostic purposes!). DO NOT drive or operate machinery, and DO NOT drink alcoholic beverages.

If your spinal procedure used corticosteroids and you are a diabetic, please closely monitor your blood sugar levels. If they reach dangerous levels, you may need to seek medical attention.

If you have any questions about your procedure, please call your personal physician for details.

Insurance / Fees

Most insurance plans cover these treatments, and we will attempt to verify with your insurance company concerning your individual policy before the day of the procedure. Please bring your insurance or Medicare/Medicaid card with you to the Interventional Spine Center.

Charges include the use of the Interventional Spine Center facilities and all supplies, drugs, and materials used during your stay. If you do not have medical insurance, a deposit will be required when you register. Your physician will bill you separately for your prior consultation visit, the procedural treatment, and follow-up visit(s).


OrthoArkansas Surgery Center Employment Application
OrthoArkansas Surgery Center Notice of Privacy Practices
OrthoArkansas Surgery Center Patient Rights


International Spine Intervention Society

North American Spine Society

American Academy of Physical Medicine and Rehabilitation

American Association of Orthopaedic Surgeons


Enter the Surgery Center through the back or South entrance of the building.  Please check in at this location 30 minutes prior to your procedures.

Pain Center Physicians


Stephen Paulus, M.D.

Stephen Paulus, M.D.

Mark L. Miedema, M.D.

Mark L. Miedema, M.D.