About United Spine Medicine
United Spine Medicine is a division of United Medical Doctors, located in Murrieta, and proudly serving the greater Southern California region. Specializing in interventional spine medicine including innovative outpatient minimally invasive procedures, United Spine Medicine strives to ensure each patient receives unparalleled specialty care.
Our Mission
We are dedicated to providing unparalleled and comprehensive specialty care to patients suffering from conditions and diseases associated with spine pain.
Our practice strives to demonstrate compassion while maintaining high reliability as we aim to fulfill a superior patient-centered experience. We thank you for the opportunity to be a part of your healthcare team.
Conditions Treated
This includes pain the neck and low back.
This is pain in the joints that sit where the lower spine and pelvis meet, as well as pain in the buttocks.
This includes burning pain or ache that radiates down the buttocks and into the legs, that typically worsens with standing or walking and gets better with leaning forward. This also contributes to declining standing and walking ability.
This includes heavy feeling and pain in the lumbar spine that refers into the legs with standing and walking. It is relieved with sitting or stooping forward such as leaning on a shopping cart. One’s standing and walking ability is declining steadily.
This includes intra-disc imaging, intra-hip imaging and more.
This is a distinct type of chronic low back pain caused by damage to vertebral endplates, the interface between the disc and the vertebral body.
This is a degenerative condition in which changes in the discs, ligamentum flavum, and facet joints with aging cause narrowing of the spaces around the neurovascular structures of the spine.
Vertebral compression fractures happen mostly in people with osteoporosis. It can happen without known trauma as well.
Minimally Invasive & Innovative Treatment Options
Key Advantages Over Open Surgery
- No Cutting
- Lower Risk
- No General Anesthesia Needed
- Less Painful Procedure
- Faster Recovery
- Outpatient – Usually Go Home in an Hour
- Preserves the More Invasive Options of Open Surgery
- Lower Cost
Intracept Procedure for Axial Pain
Vertebrogenic pain is a distinct type of chronic low back pain caused by damage to vertebral endplates, the interface between the disc and the vertebral body. Disc degeneration, and the wear and tear that occurs with everyday living, produces stresses on the endplates that damage them, leading to inflammation and vertebrogenic pain.
The disc and endplate are both part of the anterior spinal column and produce similar low back pain symptoms. However, endplate pain is associated with distinctive changes on routine MRI called Modic changes.
Patients who find relief from the Intracept Procedure often describe pain in the middle of their low back that is made worse by physical activity, prolonged sitting, and bending forward, or with bending and lifting.1
To confirm that a patient has vertebrogenic pain, physicians use MRI to look for specific changes that occur with endplate inflammation, which are called Modic changes.
The basivertebral nerve enters through an opening in the back of the vertebral body and branches near the center of the vertebral body, sending nerves to innervate the superior and inferior endplates. These nerve endings transmit pain signals from the endplate to the brain and have been shown to increase in number with endplate damage or degeneration.
Let’s Get to It: What the Intracept Procedure Involves
Under fluoroscopic guidance, the Intracept® Introducer Cannula Assembly is advanced through the pedicle.
The Intracept® Curved Cannula Assembly is used to create a channel to the trunk of the basivertebral nerve.Patients who find relief from the Intracept Procedure often describe pain in the middle of their low back that is made worse by physical activity, prolonged sitting, and bending forward, or with bending and lifting.1
The Intracept® RF Probe is inserted into the curved path and placed at the trunk of the basivertebral nerve.
The Intracept® RF Generator is used to deliver radiofrequency energy that ablates the basivertebral nerve.
mild® Procedure for Lumbar Spinal Stenosis (LSS)
A condition in which the lower spinal canal narrows and compresses the spinal nerves in the lower back. Best visualized as a “kink in a drinking straw,” this compression can contribute to pain and mobility issue.
Patients report pain when standing, walking or sleeping, and often experience relief when sitting forward or bending forward. Common actions include finding a chair, leaning over shopping cart, using walker or cane. Pain or numbness in the lower back when standing upright and pain, numbness, heaviness or tingling in upper legs or buttocks when walking are most common.
The mild ® Procedure is designed to get you in and out and on your way. mild ® does not require general anesthesia, implants, stitches, steroids, or opioids. The procedure can be performed using local anesthetic and light sedation and leaves no implants behind, only a Band-Aid. Patients typically resume normal activity within 24 hours with no restrictions.
Clinical Outcomes for the mild® Procedure
Cleveland Clinic 1-Year Study: Patients were able to increase their average standing time from 8 minutes to 56 minutes with less pain.2
Cleveland Clinic 1-Year Study: Patients were able to increase their average walking distance from 246 feet to 3,956 feet with less pain.2
Cleveland Clinic 5-Year Study: mild® helped 88% of patients avoid back surgery for at least 5 years while providing lasting relief.14
MiDAS ENCORE 2-Year Study: mild® has a safety profile similar to an epidural steroid injection, but with lasting results. In this study, there were no statistically significant differences in the safety profile between study groups.1
mild® is a minimally invasive procedure typically performed in an outpatient setting using only local anesthetic and light sedation. The nature of the procedure carries risks that do not apply to receiving an epidural steroid injection.
MiDAS ENCORE 2-Year Study: Patients reported an 85% patient satisfaction rate with the mild® Procedure.7
Balloon Kyphoplasty for Vertebral Augmentation
Osteoporosis, a condition characterized by low bone mass and deterioration in the micro architecture of bone tissue, causes more than 750,000 – 800,000 spinal fractures each year in the United States. Vertebral fractures are the most common osteoporotic fractures, yet approximately two-thirds are undiagnosed and untreated.
– Patients have as much as a 5-fold increased risk of another fracture within 1 year of initial fracture.
– Incidence of vertebral compression fracture increases progressively with age throughout later life.
The goal of balloon kyphoplasty surgery is to relieve pain, restore lost vertebral body height, and stabilize the fracture.
The procedure involves the insertion of two inflatable bone tamps (balloons), or IBTs, into the vertebrae. The IBTs are inflated under volumetric control, reducing the fracture and pushing the endplates apart, thereby partially restoring vertebral height and correcting angular deformity.3 The newly formed cavity is filled with bone cement after IBT removal.
The balloon kyphoplasty procedure typically takes about one hour per fracture and may be performed in an outpatient setting. The procedure can be done using either local or general anesthesia; the specialty physician will determine the most appropriate method, based on the patient’s overall condition.
Balloon Kyphoplasty: Procedure Steps & Duration
Through a pair of small incisions, each approximately 1 cm in length, the specialty physician uses a needle and cannula to create a small pathway into each side of a fractured vertebral body.
A small balloon is guided through each cannula into the vertebra. Each balloon is carefully inflated to raise the collapsed vertebra and return it to its normal position. Inflation of the balloon creates a void (cavity) in the vertebral body. Once the vertebra is in the correct position, the balloons are deflated and removed.
The resultant cavities are filled with bone cement.
This forms an “internal cast” to support the surrounding bone and prevent further collapse.
Outpatient Surgical Centers
Outpatient procedures and surgeries are conducted in our outpatient surgical centers, United Surgery Centers, in Temecula and Encinitas, as well as at area hospitals in both Riverside and San Diego Counties. Featured here is United Surgery Center – Temecula, our largest state-of-the-art out-patient surgery center.
Our Spine Medicine Team
Vance Z. Johnson, MD
Bahnam Thomas, DO
Our Locations
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