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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: The use of epidurography is usually performed to help document adequate delivery of pharmaceutical substrates into the epidural space. This imaging procedure also provides important information about the structural configuration of the epidural space. Epidurography can be used to identify the space that is going to be injected and to also confirm the pattern of migration of the injected agent. The use of therapeutic substances in the thecal sac can cause complications especially with repeated approaches. Fluoroscopic image guidance and correct needle placement will reduce the risk for complications. If accurate needle placement is not achieved the application of therapeutic or pharmaceutical substances may be delivered into tissues where they will be ineffective. After confirming the appropriate location, therapeutic substances can be injected through the same needle without a change of position.
Prior to the implementation of the procedure, it is necessary for the attending specialist to review all appropriate imaging studies to adequately identify the structural anatomy as well as any disease process that might be present at the targeted site for injection. To perform the procedure, the patient is generally placed in a face down position. Fluoroscopic image guidance is typically utilized for epidurography and during placement of the steroidal agent. It is also used to observe and track the distribution of the injected pharmaceutical agents
Different methods of injecting steroidal agents: The steroidal agent is injected directly into the epidural compartment. A transforaminal epidural injection may be used for those patients who have one-sided nerve root symptoms. This is a more specific approach to the region of the nerve root. A sacral or tailbone approach can also be utilized. A similar injection approach can be performed in the neck and mid back regions.
Goals of the procedure: The primary goal of the procedure is to reduce inflammation in the tissues within the epidural space including the nerve roots. The secondary goal is to reduce pain as a result of reducing inflammation. Some patients may experience improvement in muscular function. Successful reduction of nerve inflammation will improve the efficiency of nerve signal transmission.
Automated Percutaneous Lumbar Discectomy
Automated percutaneous lumbar discectomy (APLD) developed to achieve a minimally invasive treatment for lumbar disc herniations with a high success rate. Research has shown that APLD is one of the safest surgical treatments available for the care of herniated lumbar discs. The procedure incorporates the use of an operating microscope. The reduced size of the incision contributes to a reduction of complication rates. APLD is proposed to work by reducing pressure within the central portion of the intervertebral disc. Reduced pressure on the annulus and within the central portion of the disc will result in decreased size of the herniation. The success rate of APLD has been reported to range from between 40% and 90%. There are other forms of percutaneous disc removal, which include laser disc decompression, and bipolar percutaneous disc decompression, which requires that endoscopy be placed into the disc during removal.
Prior to the implementation of the procedure, it is necessary for the attending specialist to review all appropriate imaging studies to adequately identify the structural anatomy as well as any disease process that might be present at the targeted site for injection. To perform the procedure, the patient is generally placed in a face down position. Fluoroscopic image guidance is typically utilized for epidurography and during placement of the steroidal agent. It is also used to observe and track the distribution of the injected pharmaceutical agents
Different methods of injecting steroidal agents: The steroidal agent is injected directly into the epidural compartment. A transforaminal epidural injection may be used for those patients who have one-sided nerve root symptoms. This is a more specific approach to the region of the nerve root. A sacral or tailbone approach can also be utilized. A similar injection approach can be performed in the neck and mid back regions.
Goals of the procedure: The primary goal of the procedure is to reduce inflammation in the tissues within the epidural space including the nerve roots. The secondary goal is to reduce pain as a result of reducing inflammation. Some patients may experience improvement in muscular function. Successful reduction of nerve inflammation will improve the efficiency of nerve signal transmission.
Automated Percutaneous Lumbar Discectomy
Automated percutaneous lumbar discectomy (APLD) developed to achieve a minimally invasive treatment for lumbar disc herniations with a high success rate. Research has shown that APLD is one of the safest surgical treatments available for the care of herniated lumbar discs. The procedure incorporates the use of an operating microscope. The reduced size of the incision contributes to a reduction of complication rates. APLD is proposed to work by reducing pressure within the central portion of the intervertebral disc. Reduced pressure on the annulus and within the central portion of the disc will result in decreased size of the herniation. The success rate of APLD has been reported to range from between 40% and 90%. There are other forms of percutaneous disc removal, which include laser disc decompression, and bipolar percutaneous disc decompression, which requires that endoscopy be placed into the disc during removal.
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