WHAT IS Neurotomy ?

Facet neurotomy is a procedure which results in interruption of the nerve supply to a facet joint. This interruption known as denervation, is accomplished by a radio-frequency probe that heats the 2 small nerve branches to each facet joint. These nerves are called the medial branches.


HOW IS IT DONE? A local skin anesthetic is given near the base of the neck on the affected side. A needle is inserted by the anesthesiologist near the transverse process of the cervical spine (usually at the
cervical-6 level). A sterile tubing is attached to the needle and anesthetic medication is slowly injected through the tubing.


EXPECTED RESULTS: The patient may note increased warmth and redness of the painful arm during and after the injection. The patient can expect hoarseness of their voice, redness of the eye, drooping of the eyelid and pupillary constriction for four to eight hours after the injection.
Pain relief may be noted immediately. Duration of relief is variable.
The patient must assess their pain relief over the first three to four hours after the injection and report this to the anesthesiologist.

HOW LONG DOES IT TAKE? It takes less than thirty minutes for the procedure followed by evaluation and recovery for several hours. Facet Block

WHAT IS IT? A block that is performed to confirm that a facet join is the source of pain and decrease pain and inflammation in a facet joint or joints.

HOW IS IT DONE? The patient is given a local skin anesthetic - a needle is then inserted into the facet joint or facet capsule and an anesthetic and steroid are injected by the physician. This is done under fluoroscopy.

EXPECTED RESULTS: Decrease in or relief of back pain.

HOW LONG DOES IT TAKE? Thirty minutes. Blocks are done in conjunction with physical therapy. Epidural Block


WHAT IS IT? A block that is performed to determine if a specific spinal nerve root is the source of pain and reduce inflammation around the nerve root thus decreasing or relieving the pain. HOW IS IT DONE? The patient is given a local anesthetic. The physician then locates, under fluoroscopy, a specific spinal nerve root. A needle is introducted through the skin into the area adjacent to the nerve root. Medication is then injected into the area bathing the nerve root. The medications include an anesthetic and steroid. A block that is performed under fluoroscopy to confirm a specific diagnosis and/or decrease pain and inflammation.


HOW IS IT DONE? A local skin anesthetic is given. A spinal needle is then inserted into the epidural space of the lumbar or caudal spine. An anesthetic and steroid are injected into the epidural space.

EXPECTED RESULTS: Relief of pain if the medication reaches the inflamed area or source of pain.

HOW LONG DOES IT TAKE? Thirty minutes plus approximately forty-five minutes recovery time. Selective Nerve Root Block

So at last it can be concluded that Neurotomy is a medical term. To cure it the patient is inserted a needle neat the base of the neck of the effected side and the process is performed very slowly. Thereafter the patient feel heat and redness of the infected area during the injection or after the injection.

Dr. Arden Kaisman

Dr. Kaisman completed his medical school training at The Albert Einstein College of Medicine in the Bronx in 1984. Clerkships were performed at Jacobi Medical Center, North Central Bronx Hospital and Montefiore Medical Center. He then underwent three years of General Surgery training at Kings County Hospital/SUNY Health Science Center in Brooklyn, New York. He worked at Kings County Medical Center, Downstate Medical Center, The Brooklyn VA Medical Center, Woodhull Hospital and St. Vincent's Medical Center in Staten Island. Dr. Kaisman worked at the Kings County Medical Center world famous Level I Trauma Center. In July, 1988, Dr. Kaisman began three years of Anesthesiology residency at The Mount Sinai Medical Center in Manhattan rotating thru Mount Sinai Hospital, The BronxVA Medical Center and Elmhurst Hospital. The last year was spent in Cardiovascular Anesthesiologyat Mount Sinai Hospital which included pediatric Cardiac Anesthesi a.

Dr. Kaisman began practicing with Locum Tenens Anesthesiology from July 1991 thru December 2004.He worked throughout the United States providing Anesthesia and Pain Management. He worked in NY, NJ, CA, FL, MI, TN, IN, NH, MD, OH, WV, MT, AK, WY, TX,and OK.

From January 1995 until December 1995 Dr. Kaisman was an Attending Anesthesiologist at New York Downtown Hospital.

In January 1996 Dr. Kaisman went into full time private practice in Pain Management. In 1996 he became a voluntary attending physician in Pain Medicine at Cabrini Medical Center in Manhattan and remained affiliated with the hospital until it closed in June 2008. Dr. Kaisman is curerntly a voluntary attending physician at Beth Israel Medical Center in Manhattan.

Dr. Kaisman currently practices Interventional Pain Management.
Dr. Kaisman's qualifications also include the following:

• Diplomat American Board of Anesthesiology (ABMS), 1993
• Certification Pain Management (ABMS), 9/12/98.
• Diplomat, American Board of Pain Medicine,2/17/1997

Dr. Kaisman is also an active member of the following:

• Reflex Sympathetic Dystrophy Association of America
• American Trauma Society
• International Spinal Injection Society
• American Pain Society

Dr. Kaisman has an office at:
51 East 25th Street,
6th FloorNew York,
NY 10010212-813-319212-857-9415
Faxakaisman@nypaincare.com

Office Hours are Monday 9am-1pm and Thursdays 10am-5pm.Procedure Hours are Monday 2pm-6pm and Wednesday 10am-6pm.
The Manhattan office has a fully equipped Pain Management Operating Room with C-Arm Fluoroscopy where procedures are performed. These include:

• 1- Cervical,Thoracic and Lumbar Epidural Steroid Injections.
• 2- Cervical and Lumbar Facet Blocks.
• 3- Stellate Ganglion Blocks.
• 4- Lumbar Sympathetic Blocks
• 5- Trigger Point Injections.
• 6- Cervial and Lumbar Transforaminal Epidural Injections.
• 7- Cevical and Lumbar Discograms.
• 8- Occipital Nerve Blocks.
• 9- Paravertebral Nerve Blocks.

Dr Kaisman has an o ffice at: 46-15 104th StreetCorona, NY 11368 akaisman@nypaincare.com 718-476-7233718-476-7234 Fax

Office Hours are every other Tuesday 2:30pm-6:30pm.Physical Therapy Hours are Noday thru Friday 11am-7pm and Saturday 10am-3pm.

The Queens office is for consultation and Physical Therapy.

Percutaneous Lumbar Discectomy is performed at:

Beth Israel Medical Center (Manhattan) Grammercy Surgery Center (Manhattan)