Surgery appears to lead to better outcomes if there are ongoing symptoms after three to six months of conservative treatment.  Laminectomy is the most effective of the surgical treatments.  In those who worsen despite conservative treatments surgery leads to improvement in 60–70% of cases.  Another procedure using an interspinous distraction device known as X-STOP was less effective and more expensive when more than one spinal level is repaired.  Both surgical procedures are more expensive than medical management. 
Dr. Tai is certified by the American Board of Physical Medicine and Rehabilitation with subspecialty certification in Pain Medicine. He is licensed as a Physician by the New Jersey State Board of Medical Examiners and as an acupuncturist by the New Jersey State Acupuncture Examining Board. He is currently practicing pain management at his office in Bridgewater New Jersey, at Robert Wood Johnson University Hospital-Somerset, and at Somerset Ambulatory Surgical Center.
The following patients should not have this injection: if you are allergic to any of the medications to be injected, if you are on a blood-thinning medication (. Coumadin, injectable Heparin), or if you have an active infection going on. With blood thinners like Coumadin, your doctor may advise you to stop this for 4-7 days beforehand or take “bridge therapy” with Lovenox prior to the procedures. Anti-platelet drugs like Plavix may have to be stopped for 5-10 days prior to the procedure. Aspirin should be stopped for cervical procedures for 10 days prior, but not for Lumbar.