When I told my doctor ‘no surgery’ for my aching back, he suggested I at least talk to a surgeon about some of the minimally invasive procedures that are available now. He called these mini-operations ‘interventional’. But I really don’t know what I’m asking about. Can you help me out here with at least a description I can take with me so I know what to say?

Interventional procedures involve a minimally invasive operation. The surgeon inserts a long needle through a tiny incision in the skin and advances it to the spine in order to carry out the procedure. This approach is called percutaneous. A special real-time X-ray called fluoroscopy is used to guide the surgeon.

Or the surgeon can make a slightly larger incision and insert a tube through which an endoscope is placed. The scope has a tiny TV camera on the end that also shows the surgeon the spine and surrounding anatomy. With the guidance offered by fluoroscopy or endoscope, the surgeon can be much more precise and accurate without making a large incision and opening the patient up.

Epidural steroids, epidural adhesiolysis, nerve blocks, radiofrequency ablation, and sacroiliac joint injections are just a few of the minimally invasive interventional treatments available. The choice of procedures depends on the cause of the problem. The surgeon will have to do some tests to identify where the pain is being generated from. It could be the disc, the spinal (facet) joints, or other soft tissues such as spinal ligaments, muscles, or even the sacroiliac joint.

Really, all you have to do is present your case exactly the way you explained it to us. The surgeon will take it from there asking you questions about your symptoms, past medical history, back injuries, and so on. Once the full picture has been drawn, it will be easier to determine the best plan of care for you based on availble evidence in the published spine literature.