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YOU are here : Home > Spinecare Topics > Intervention - Spinal Disorders > Minimally Invasive Intervention for Spine Pain
Spinecare Topics
Intervention - Spinal Disorders
Minimally Invasive Intervention for Spine Pain
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Minimally Invasive Intervention for Spine Pain
Procedure: Percutaneous biopsy can be performed in an inpatient or outpatient setting. A variety of laboratory studies are usually performed prior to biopsy. Local or general anesthesia may be used. It is usually performed with local anesthesia and intravenous conscious sedation. The patient is positioned according to the spinal level to be investigated. A needle is carefully placed under CT or flouroscopic guidance. An excision or aspiration technique is used to extract tissue or fluid.
Indications for Procedure: A spinal biopsy is often performed to assess the tissue characteristics of a destructive or space-occupying lesion. Other indications for image-guided percutaneous spine biopsy include evaluation of a primary or secondary spinal tumor, assessment of the cause of a spinal compression fracture, to help rule out an infectious process, to perform tests to identity an infectious organisms and to assess the cause of a localized inflammatory process.
Goals of the Procedure: The primary goal of the procedures is to obtain the necessary amount of tissue required for adequate evaluation while exposing the patient to the least amount of risk possible.
Radiofrequency Facet Denervation
Radiofrequency facet denervation is a procedure that is performed to anesthetize the nerve that goes to the facet joint. The procedure is performed with a needle that is placed under the guidance of X-ray. Once the needle is in place an electrode containing a heat sensor is passed through the needle. The electrode is used to apply a current that heats the nerve up just enough to destroy pain fibers within the nerve. Typically several points along the nerve are treated this way. The procedure commonly last between 30 and 60 minutes. If the facet joint was the primary source of pain successful radiofrequency denervation of that joint is usually effective at reducing or eliminating back pain.
Epidural Steroid Injection and Selective Nerve Blocks
Background: The placement of steroidal material into the epidural space has been utilized since the early 1900s. Lower back epidural injections were first described in 1901. The basis for anti-inflammatory injections within the vertebral column is based on the presence of pain sensitive nerve fibers within many of the spinal tissues. There is a double-layered membrane, which forms the outer margin of the central space within the spinal canal. This membrane and the epidural space lie within the entire length of the bony spinal canal. The epidural space completely surrounds the thecal sac, which contains all the nerve roots in the low back. Nerve root symptoms and sciatic pain are sometimes the result of a combination of mechanical compression as well as inflammatory changes. One of the more common causes of nerve compromise is degenerative disc disease and resultant disc bulge or herniation. Research has shown the presence of inflammatory cells as well as increased protein levels within the cerebrospinal of many patients with degenerative spine changes. The pharmacological basis for the use of epidural steroid injections is the presence of inflammatory changes.
Indications for Procedure: A spinal biopsy is often performed to assess the tissue characteristics of a destructive or space-occupying lesion. Other indications for image-guided percutaneous spine biopsy include evaluation of a primary or secondary spinal tumor, assessment of the cause of a spinal compression fracture, to help rule out an infectious process, to perform tests to identity an infectious organisms and to assess the cause of a localized inflammatory process.
Goals of the Procedure: The primary goal of the procedures is to obtain the necessary amount of tissue required for adequate evaluation while exposing the patient to the least amount of risk possible.
Radiofrequency Facet Denervation
Radiofrequency facet denervation is a procedure that is performed to anesthetize the nerve that goes to the facet joint. The procedure is performed with a needle that is placed under the guidance of X-ray. Once the needle is in place an electrode containing a heat sensor is passed through the needle. The electrode is used to apply a current that heats the nerve up just enough to destroy pain fibers within the nerve. Typically several points along the nerve are treated this way. The procedure commonly last between 30 and 60 minutes. If the facet joint was the primary source of pain successful radiofrequency denervation of that joint is usually effective at reducing or eliminating back pain.
Epidural Steroid Injection and Selective Nerve Blocks
Background: The placement of steroidal material into the epidural space has been utilized since the early 1900s. Lower back epidural injections were first described in 1901. The basis for anti-inflammatory injections within the vertebral column is based on the presence of pain sensitive nerve fibers within many of the spinal tissues. There is a double-layered membrane, which forms the outer margin of the central space within the spinal canal. This membrane and the epidural space lie within the entire length of the bony spinal canal. The epidural space completely surrounds the thecal sac, which contains all the nerve roots in the low back. Nerve root symptoms and sciatic pain are sometimes the result of a combination of mechanical compression as well as inflammatory changes. One of the more common causes of nerve compromise is degenerative disc disease and resultant disc bulge or herniation. Research has shown the presence of inflammatory cells as well as increased protein levels within the cerebrospinal of many patients with degenerative spine changes. The pharmacological basis for the use of epidural steroid injections is the presence of inflammatory changes.
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