Interventional Associates is a group of fully trained and experienced physicians providing the complete spectrum of musculoskeletal care from prevention and diagnosis, to treatment and rehabilitation. We strive to provide patient-centered care, giving our patients immediate and convenient access to the latest treatment protocols and procedures for auto accidents in Orlando.
Services We Offer
Our orthopedic specialists offer patients access to an unparalleled institution of knowledge. Each medical provider completes a comprehensive evaluation for each injury our patients are suffering from. With a broad range of knowledge and experience, we are able to provide answers to the severity and prognosis of an injury, while maintaining a comfortable atmosphere and excellent customer service.
In each office, you will find a committed case manager to help create a comfortable setting and guide each patient through their appointment. With direct access to them, it is easy to communicate any concerns or questions that come up. They will be your office liaison to minimize any delays and ensure the best customer service.
Our dedicated team of surgical coordinators and procedure verification specialists work together to help make the surgery scheduling process as simple as possible. From the first consultation, to the last post-operative appointment, they are by your side every step of the way. We are happy to answer any questions and ensure any logistical or financial concern is addressed.
Orthopedic Spinal Surgery
Auto accidents can cause many injuries to the spine that are sometimes permanent and need to be corrected by surgery. Our specialists have extensive training in assessing each injury and recommending surgery that is tailored to each patient's specific needs. With new technology, there are many advancements in procedures that can effectively correct the injury and provide long-lasting relief with minimal downtime and recovery.
Depending on the diagnosis and severity of the condition, surgical intervention may be recommended. Interventional Associates’s fully trained and experienced spine surgeon provides the complete spectrum of spinal care, including the following surgical specialties:
Cervical disc replacement is a surgical procedure that involves removing a damaged or degenerated cervical disc and replacing it with an artificial disc device. Cervical discs are the cushions or shock absorbers between the bones (vertebra) of the neck (cervical spine). Discs that become damaged either through trauma or degeneration can be a source of pain. If part of a disc moves out of its normal position it can cause pressure on the central spinal cord or on the individual nerve roots that exit from the spinal canal at each vertebral level.
Cervical fusion is a surgical procedure that links together damaged segments of the vertebral column in the neck. This surgery is usually required when the cervical vertebrae and the discs between each vertebra have become damaged as a result of an injury or chronic wear-and-tear.
Lumbar fusion is a surgical procedure used to correct problems with the small bones in the spine (vertebrae). It is essentially a "welding" process. The basic idea is to fuse together two or more vertebrae so that they heal into a single, solid bone.
Laminectomy is surgery that creates space by removing the lamina — the back part of a vertebra that covers your spinal canal. Also known as decompression surgery, laminectomy enlarges your spinal canal to relieve pressure on the spinal cord or nerves. Laminectomy is surgery that creates space by removing the lamina — the back part of a vertebra that covers your spinal canal. Also known as decompression surgery, laminectomy enlarges your spinal canal to relieve pressure on the spinal cord or nerves.
Discogram is an invasive diagnostic test that uses x-rays to examine the intervertebral discs of your spine. A special dye is injected into the injured disc or series of discs. The dye makes the disc visible on a fluoroscope monitor and x-ray film. The procedure involves pressurizing discs by injecting them with a sterile liquid to induce pain in the affected discs.
Using fluoroscopy as a guide, the probe is inserted into the basivertebral nerve where radiofrequency is utilized to ablate the nerve. This is an implant free, minimally invasive, outpatient procedure.
A minimally invasive surgery where they use radiofrequency in the disk using an innovative, minimal access spine system designed to efficiently access the damaged disc without injury to surrounding disc anatomy.
Orthopedic Extremity Surgery
Our orthopedic extremity services include evaluation and treatment of bone and joint injuries related to auto accidents. We provide minimally invasive surgery, surgical reconstruction and arthroscopic treatment options for shoulders, knees, and carpal tunnel release. We utilize cutting-edge technology to provide minimally invasive options such as arthroscopic surgery, which can be performed in less time and with less discomfort than conventional surgery.
Depending on the diagnosis and severity of the condition, surgical intervention may be recommended. Interventional Associates’s fully trained and experienced extremity surgeon provides the complete spectrum of musculoskeletal care, including the following surgical specialties:
Shoulder arthroscopy is surgery that uses a tiny camera called an arthroscope to examine or repair the tissues inside or around your shoulder joint. The arthroscope is inserted through a small cut (incision) in your skin.
SLAP lesion repair is a surgical procedure to repair a tear resulting from an injury to the labrum located in the shoulder joint. SLAP is an acronym for Superior Labrum from Anterior to Posterior. This refers to a tear where the tendon of the bicep muscle joins the labrum.
Synovectomy is a procedure where the synovial tissue surrounding a joint is removed. This procedure is typically recommended to provide relief from a condition in which the joint lining becomes inflamed and irritated and is not controlled by medication alone.
Limited debridement of soft or hard tissue and should be used for limited labral debridement, cuff debridement, or the removal of degenerative cartilage and osteophytes. This would consist of work done in just a portion of the shoulder, such as the front or the back of the shoulder.
Surgery to repair a torn rotator cuff most often involves reattaching the tendon to the head of humerus (upper arm bone). A partial tear, however, may need only a trimming or smoothing procedure called a debridement. A complete tear is repaired by stitching the tendon back to its original site on the humerus.
Knee Meniscectomy is an outpatient minimally invasive surgical procedure used to treat a torn meniscus cartilage in the knee. Only the torn segment of the meniscus is removed.
Surgery to smooth and reshape cartilage by scraping, cutting, or shaving it. An outpatient minimally invasive surgical procedure used to treat a torn meniscus cartilage in the knee.
Anterior cruciate ligament reconstruction is a surgical tissue graft replacement of the anterior cruciate ligament, located in the knee, to restore its function after an injury. The torn ligament is removed from the knee before the graft is inserted in an arthroscopic procedure.
Carpal tunnel release is a surgery used to treat and potentially heal the painful condition known as carpal tunnel syndrome. The carpal tunnel is formed by the wrist bones on the bottom and the transverse carpal ligament across the top (or inside) of the wrist. When this part of the body is injured or tight, swelling of the tissues within the tunnel can press on the median nerve. During a carpal tunnel release, a surgeon cuts through the ligament that is pressing down on the carpal tunnel. This makes more room for the median nerve and tendons passing through the tunnel, and usually improves pain and function.
Meet The Team
M. Christopher MacLaren D.O., FAOAO
Andrew Messer, M.D., FRCS (Canada), FAAOS (USA)
J. Lucas Koberda, MD, PhD
Dylan Saulsbery, DC, DIBCN, DIBE
Augusto Cianciabella, PA-C
Catherine Hurley APRN-BC
Brittany Wright, PA-C
Felicia Danio, DC, DIBCN
Bradley Goodman, MD
Carmel Lacey, APRN-BC
Donald Goldman, MD, FAADEP, CLCP
Gabrielle Dobson, APRN-C
John Morrison, MD
Ryan Revels, DC, DIBCN, DIBE
Interventional Pain Management
This is a minimally invasive option to help reduce pain and regain function through non-surgical procedures. We want to help our patients return to their daily activities without the burden of spinal and joint pain. After a thorough evaluation and review of diagnostic imaging, our specialists can offer the best option for your specific ailment. Our doctors have extensive training in numerous pain management techniques that have been clinically proven to help reduce or eliminate pain from auto injuries.
An epidural steroid injection delivers steroid medication directly into the epidural space in the spine. At Interventional Associates, a solution containing Depo Medrol (steroid) with Saline is used.
What is the benefit?
Steroid medications are powerful anti-inflammatory agents, which helps reduce inflammation around the spinal nerves which may be irritated due to a herniated or bulging disc. The saline mixed into the injection works by “flushing” or diluting the body’s automatic inflammatory fluids, also reducing pain.
Facet blocks or medial branch blocks involve injecting a small amount of local anesthetic (numbing agent) into the facet joint or surrounding the medial branch sensory nerve, depending on the specific approach.
What is the benefit?
By placing the numbing agent specifically around either the facet joint or the medial branch nerve, the level of immediate pain relief experienced will confirm that the area injected is the source of pain. In other words, it is a diagnostic test. This procedure is not meant for long term relief but can benefit some patients for longer than the expected 1 to 3 hours.at they heal into a single, solid bone.
Radiofrequency neurotomy is a type of procedure used to treat joint/nerve pain. In this technique, radiofrequency energy is used to burn, or cauterize, the sensory nerve. This approach interrupts the sensory nerve’s pain signal to the brain; it does not affect the major spinal nerves responsible for strength and sensation. A steroid medication can optionally be used to aid in the healing process.
What is the benefit?
The RFN will often provide long term pain relief lasting an average of 9 to 14 months, and sometimes even longer since the nerve may regenerate, and the pain may or may not return. Because it takes time for the nerve to completely nullify, pain relief may not become apparent for 3 to 5 weeks. RFN will provide the same, if not better relief of pain as the Medial Branch Block, because RFN would not be performed unless there was significant relief with the Medial Branch Block.
A large joint injection delivers an effective combination of steroid medication and local anesthetic, usually Lidocaine or Bupivacaine, to coat the lining of the joint capsule. They can be performed in most large joints of the body, but the most common regions are the knee, shoulder, hip, or sacroiliac (SI) joint, located where the lower back meets the pelvis.
What is the benefit?
Steroid mediations are strong anti-inflammatory agents that help reduce inflammation in the joint, which may be irritated due to injury or other conditions. Once the inflammation is calmed, pain lessens, swelling reduces and redness disappears. The local anesthetic mixed into the injection works to reduce pain by “flushing” or diluting the body’s immune response consisting of inflammatory fluids, damaged cells and tissue debris. Local anesthetic also temporarily numbs the joint to aid in post-procedural discomfort.
Trigger points (knots) can occur anywhere in the skeletal muscle. Most notably, they are found in the Cervical, Thoracic and Lumbar regions. This can result in discomfort in multiple areas that range in severity of symptoms. Trigger points are specific, hyper-irritable and hyper-sensitive areas in the muscles. They cause the muscle to suffer from a decrease blood circulation, increased contraction and spasm, and a buildup of toxins and waste. Symptoms can range from a dull ache to a sharp pain. When a substance is injected into a tight muscle, the fibers are spread and smoothed out which increases function and reduces pain.
Typically, Lidocaine is used to treat this condition. It is a short-acting local anesthetic agent. Lidocaine numbs the area short term, but breaks up the adhesions long-term, thus correcting the problem by shrinking the trigger points. It also allows the patient to treat the area more thoroughly because the area is temporarily numb. The tighter the muscle, the sorer it can be after being treated. Often, a repeat injection is necessary to maintain results.
Life Care Planning and Medical Cost Assessment
What is a Medical Cost Assessment?
At Interventional Associates, our dedicated team works to provide you with a detailed Medical Cost Assessment (MCA) outlining your client's individual medical condition, future medical requirements, and associated costs. Following an executive summary, you will find a detailed report of causally related future care recommendations and the associated dollar amounts in today's costs of care. Costs are calculated in totality to the patient's life expectancy based upon the most recent version of the CDC's National Vitals Statistics Report. All reports are finalized by our Certified Life Care Planner, Dr. Donald Goldman, MD, awarded to him by the International Commission on Health Care Certification Board. Dr. Goldman will personally evaluate every client and conduct a thorough review of the medical records to formulate his recommendations for the MCA.
What is a Life Care Plan?
A life care plan is a detailed report of a person’s financial needs and expenses following sustaining injuries from an auto accident. The report considers each patient's entire circumstance including medical costs, follow up care, and the costs of daily living. The life care plan report is a detailed way to plan for a patient's future expenses based on their injuries and life expectancy. Our Certified Life Care Planning Physician accounts all medical needs and living needs of the patient for the rest of their life. They will review medical bills, home modifications that may need to be made to accommodate certain injuries, medical supplies, lost income, and the projected life expectancy.
What happens after an LCP or MCA is requested?
Once the request is received by our team, they will gather all necessary information. Records requests may be sent for any missing documents or reports and the patient will be scheduled to meet with the Certified Life Care Plan Physician.
All requests must be sent to firstname.lastname@example.org or email@example.com to be properly processed. After a request is processed, our team will reach out to you for confirmation of receipt.
Our Certified Life Care Plan Physician
Dr. Donald I. Goldman, M.D., FAADEP, CLCP, Life Care Planner Certification awarded to him by the International Commission on Health Care Certification.
Dr. Goldman is a Certified Life Care Planner by the International Commission on Healthcare Certification Board. Through comprehensive examinations and analysis of medical records, he provides an organized, concise plan for current and future needs with associated cost for individuals who have experienced
catastrophic injury. Dr. Goldman also has had an impressive career as an Orthopedic Consultant at his Orthopedic Surgery Private Practice for the passed forty years consulting for prestigious organizations and associations.
- Pricing is based on region and I or potential impairment.
- Minimal (impairment classification II), Moderate (impairment classification Ill), Moderate to Severe (impairment classification IV), and Severe (impairment classification V) as outlined In the AMA guidelines for rating impairment.
- Once the initial evaluation is performed, a comprehensive report takes from 4 to 6 weeks. Under URGENT circumstances we will be able to complete a report In a week.
Our board-certified neurologist focuses on neuropsychiatry and cognitive enhancement to help those who suffer from neurological symptoms after an auto accident. We utilize the newest technology to successfully diagnose and treat many medical conditions including concussions, Traumatic Brain Injury, headaches, and other symptoms that can be caused by trauma due to an accident. After a thorough evaluation, treatment strategies are geared at improving specific neurological deficits and optimizing the brain’s adaptability or neuroplasticity. We offer cutting edge testing including quantitative EEG and Brain Mapping Research, EMG/NCV, and VNG testing along with proper referrals and recommended cognitive exercises.
Treatment strategies are geared at improving specific neurological deficits and optimizing the brain’s adaptability or neuroplasticity. Neuroplasticity is the changing of neurons, the organization of their networks, and their function with the brain throughout life. Treatment may include stimulation of the vestibular (balance), auditory, visual or other sensory systems, cognitive exercises, neuromuscular re-patterning or reeducation, chiropractic manipulative therapy and physical therapy.
They utilize the below tests, blood work results, vestibular and cognitive exercises and nutritional advice to achieve the best possible outcomes. They also can refer patients to other specialists such as a Neurologist, Psychiatrist or Orthopedic Specialist to ensure their symptoms are properly addressed and managed.
What kind of tests do Neurologists use?
Quantitative electroencephalography (QEEG) is an electrical neuroimaging process that has proved to be a precise method in identifying brain areas with electrical dysfunction related to either traumatic injury or neurodegenerative process. The clinical usefulness of QEEG is shown through evidence of electrical abnormalities and networks dysfunctions.
What is a QEEG test?
An electroencephalogram (EEG) is a test that detects electrical activity in your brain using small, gel-like electrodes attached to your scalp via a harness worn on the head. Your brain cells communicate via electrical impulses and are active all the time, even when you’re asleep. The EEG will record your brain activity and the results will be analyzed to determine how well your brain is functioning.
What to expect?
You may experience mild discomfort during the EEG as the cap on your head has to be snug to ensure it is recording your brains electrical activity. The electrodes don’t transmit any sensations. They just record your brain waves.
- A technician will place the harness on your head, and separate your hair to reveal your scalp.
- Water soluble gel is applied to the scalp to prep for the electrodes. It washes out, but it can mess up your hair, so it is advised to bring a hat/hair-tie/or brush with you.
- The testing requires the patient to remain extremely still, with minimal movements. So, please dress comfortably.
- Applying the electrodes takes time. But, once they are in place, an EEG typically takes up to 30 minutes. So, plan for at least an hour.
What is a Nerve Conduction Velocity Test and Electromyography Exam?
Electromyography (EMG) and nerve conduction velocity (NCV) are electrodiagnostic tests that measure the electrical activity of muscles and nerves.
What to Expect?
- EMG: You may feel discomfort when the needle electrodes are inserted.
- NCV: You may feel startled when the electrical pulses are generated.
- After EMG: The muscle(s) tested may feel sore, and you may have minor bleeding or bruising where the needle electrodes were inserted.
How to Prepare for NCV/EMG Test
- Avoid skin lotion or cream on the areas to be tested
- During the test, you may be instructed to sit and/or lay down
After a car accident, dizziness and discomfort may be experienced. Motor vehicle accidents are traumatic on the body and brain. If you are diagnosed with whiplash, then you are at a higher risk for a vestibular injury. Whiplash injuries often affect the area of the brain responsible for your balance, spatial awareness, and coordination. That is because the violent whipping motion your body experienced in the car accident affected the area of your neck and base of the skull that is responsible for sending information toward the vestibular system.
What is a Videonystagmography (VNG)?
Videonystagmography (VNG) is used to evaluate how the inner ear is functioning. Since one of the main functions of the balance system is to keep our visual world steady during head movements. Every time the inner ear senses a head movement, the eyes move in an equal and opposite direction. Because of this feature, we can use eye movements to study the inner ear. The test is non-invasive and involves several parts.
What to expect?
- First, the patient is asked to visually track targets that will either jump around (saccades) or move continuously (smooth pursuit). This part tests the oculomotor system, which is the neural network that controls eye movements.
- Second, positional nystagmus is assessed, with placing the patient into certain positions that may cause dizziness. This is important to see if the dizziness is related to a problem in the inner ear called Binomial Proximal Positional Vertigo.
- Finally, caloric testing is performed, which involves placing hot and cold air or water into each ear to stimulate the inner ear. The speed of the resulting eye movements is then measured. This test is helpful for determining if the inner ears are functioning properly, or if one or both are damaged.
How to prepare for Videonystagmography (VNG):
- Avoid the use of any make-up (mascara, eyeliner or false eyelashes)
- Bring a driver with you or we can provide transportation
- Avoid caffeine soft drinks, tea, decaf caffeine, chocolate or alcohol at least 48 hours prior to testing.
- No food or drinks 4 hours before testing begins (in the case you are diabetic, a snack or light meal is accepted IF NEEDED 4 hours before test)
- Please come in loose fitted clothing
- Avoid the use of perfumes/cologne
- Avoid having wet/damp hair for Videonystagmography (VNG).
- Discontinue any medication for pain, anxiety (if possible), anti-histamines, anti-dizziness or/and anti-depressants.
"Dr. Bundy has treated me for my back pain with spinal injections. It was incredibly effective and surprisingly painless he has a wonderful touch and his manner and patience are really refreshing. His assistance for the procedure was really nice and professional too. I have recommended them to friends and family. Thank you Doctor Bundy."
"I had a wonderful experience visiting this office. Everyone was exceptionally friendly and personable. They were very thorough with the procedures that I would need and explained everything to make me feel comfortable. All of my questions were answered professionally and I highly recommend for treatment with pain."
"From day one of my visit, this office was very welcoming, also attentive, smiling and very politely mannered. I highly recommended this business to anyone."
"Every girl in the office is very sweet, caring, nice. I appreciate all of them the P.A is superb guy, he is very nice and a very good team all together. Thanks to all you guys."
"This place is amazing!!! The staff was extremely professional and compassionate. I went in feeling very nervous and left with answers to all my questions. The treatment helped significantly and gave me a new outlook. I wish I could give this place 10 stars."
"Don't like the reason why I have to come, but I love seeing each soul from the smiling person that greets me as I make my clumsy entrance to, the gentle hand that takes my blood pressure with a smile as well the doctors. Love that office!!!"
"Interventional Associates is by far the most professional place for helping you with your pain and the excellent concierge service by the staff. Orthopedic surgical consultations and care are outstanding. Dr Messer, Mrs Rachel, Ms Katie all displayed excellent care. I refer my Interventional Associates to all located on Magnolia."
"I truly give each and every staff member in the interventional associates a 5 star, they are so understanding always willing to accommodate, and highly recommend anyone with slip and fall to auto accident to come to interventional associates , you will not be disappointed!!!!!!"
Interventional Associates FAQs
During your first visit, you will have a comprehensive medical examination where our board-certified physicians will take a thorough history and perform a physical exam. Our physicians identify possible areas that are causing your pain and explain different procedures that are available to reduce pain.
Our interventional pain physicians diagnose and treat people who have pain in the neck, back, arms, and legs that has been caused by an injury from an auto accident. They will perform a comprehensive exam, review all applicable imaging and testing and formulate a care plan that best fits your needs.
As an interventional pain office, we try to create individual, comprehensive treatment plans to effectively treat your specific pain condition. Our primary focus is on interventional techniques but can also prescribe other modalities such as durable medical equipment, such as back braces and TENS units, and physiotherapy. After a thorough evaluation, our physicians will ensure each patient is receiving the best plan for their individual needs and make any necessary referrals.
Most injections are outpatient procedures done in our clinic, which means that the procedure is done without being admitted to a hospital. All patients go home within an hour of their appointment time unless otherwise instructed by the physician.
When scheduling your procedure you will be given specific instructions on how to prepare. Please follow these instructions to ensure your safety and to prevent your procedure from being rescheduled or postponed. There is a list of medications provided that you will need to abstain from for seven days prior to your procedure. If you are on medications that require clearance from your primary physician, we will need to verify that clearance is received prior to your procedure date. If there are any questions, your case manager or surgical coordinator will be happy to help.