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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 procedure should be performed in a diagnostic imaging (fluoroscopic) suite. Depending on the level of the spine to be addressed, the patient will be positioned in the most efficient position required to place the needle. The nerve root sheath can be safely injected within the neuroforamen.
Goals of the procedure: The primary goal of the procedure is to reduce inflammation and subsequently reduce nerve root symptoms including pain. The select approach to an isolated nerve root helps minimize risk to adjacent spinal structures and adjacent neurological levels. Selective nerve root injections are considered relatively safe. They are usually performed in an outpatient setting. They are best performed with imaging guidance in conjunction with the appropriate contrast agents.
Diagnostic Epidurography and Therapeutic Epidurolysis
Background: Epidurography and epidurolysis was first introduced in the mid 1980s. The approach is often referred to as the RACZ procedure. Epidurolysis has gained widespread acceptance within the pain management community. The presence of scar tissue in the spine can lead to the generation of pain. It can occur due to a variety of mechanisms. The most common cause of epidural fibrosis is post-surgical scarring. The presence of scar tissue is not necessarily limited to the side of surgical intervention, it may occur on the opposite side and sometimes both sides. Progressive scar tissue formation can cause a space occupying mass effect, which can inhibit transmission of therapeutic agents injected into select areas of the spine.
Studies have demonstrated that the back (posterior) aspect of the disk and the posterior longitudinal ligament, which runs along the posterior aspect of the disk have pain endings and therefore can contribute to low back pain. Injury to these tissues can contribute to the development of adhesions, which might adhere to adjacent nerve roots within the neuroforamen. The use of epidurography or specific imaging of the epidural space is sometimes required to direct adequate treatment. The fluoroscopically guided epidurogram and epidurolysis treatment offers distinct advantages over the epidural steroid injection. Epidurography can be used to help determine suspected pain generators.
The use of image guided catheter placement for the administration of epidural steroid (anti-inflammatory) agents has definite advantages over non-directed approaches. The use of epidurography helps determine whether the injection site is epidural, subdural or subarachnoid. Epidurography can be used to guide the breakdown of adhesions through mechanical catheter placement and/or trough a series of injections. The breakdown or elimination of scar tissue (epidural adhesions) can help reduce pain and open channels for pharmaceutical agent migration.
Goals of the procedure: The primary goal of the procedure is to reduce inflammation and subsequently reduce nerve root symptoms including pain. The select approach to an isolated nerve root helps minimize risk to adjacent spinal structures and adjacent neurological levels. Selective nerve root injections are considered relatively safe. They are usually performed in an outpatient setting. They are best performed with imaging guidance in conjunction with the appropriate contrast agents.
Diagnostic Epidurography and Therapeutic Epidurolysis
Background: Epidurography and epidurolysis was first introduced in the mid 1980s. The approach is often referred to as the RACZ procedure. Epidurolysis has gained widespread acceptance within the pain management community. The presence of scar tissue in the spine can lead to the generation of pain. It can occur due to a variety of mechanisms. The most common cause of epidural fibrosis is post-surgical scarring. The presence of scar tissue is not necessarily limited to the side of surgical intervention, it may occur on the opposite side and sometimes both sides. Progressive scar tissue formation can cause a space occupying mass effect, which can inhibit transmission of therapeutic agents injected into select areas of the spine.
Studies have demonstrated that the back (posterior) aspect of the disk and the posterior longitudinal ligament, which runs along the posterior aspect of the disk have pain endings and therefore can contribute to low back pain. Injury to these tissues can contribute to the development of adhesions, which might adhere to adjacent nerve roots within the neuroforamen. The use of epidurography or specific imaging of the epidural space is sometimes required to direct adequate treatment. The fluoroscopically guided epidurogram and epidurolysis treatment offers distinct advantages over the epidural steroid injection. Epidurography can be used to help determine suspected pain generators.
The use of image guided catheter placement for the administration of epidural steroid (anti-inflammatory) agents has definite advantages over non-directed approaches. The use of epidurography helps determine whether the injection site is epidural, subdural or subarachnoid. Epidurography can be used to guide the breakdown of adhesions through mechanical catheter placement and/or trough a series of injections. The breakdown or elimination of scar tissue (epidural adhesions) can help reduce pain and open channels for pharmaceutical agent migration.
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