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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
Indications: Indications for the procedure include unresponsiveness to an adequate course of conservative therapy, lack of an obvious source of pain, and absence of focal neurological deficits in the involved extremities.
Procedure: Epidurography and epidurolysis can be performed at any level of the spine ranging from the tailbone to the top of the cervical spine. Laboratory studies are generally performed prior to the procedure. The studies might include a complete blood count and clotting (coagulation) studies. The patient is generally placed on a cushioned fluoroscopy table. Special pillows will be used to mount the patient up into the necessary and a comfortable position. A local anesthetic agent is applied. The needle is then incrementally guided into the epidural space. A RACZ catheter, which was designed specifically for this purpose, is put into position. Under image guidance, the catheter is placed into the specific area of pain generating fibrosis. Guiding the catheter tip into an area filled with enlarged or dilated veins and scar tissue can be an extremely challenging task.
Once the target site is identified a contrast medium is injected to demonstrate the speed of contrast injection. This helps determine if there might be a filling defect. Once a steroid and local anesthetic is injected, an approximate 30-minute wait time is utilized to allow for significant sensory and motor blockade. A hypertonic saline solution is then injected under pressure to help breakup scar tissue.
Goals of the procedure: The primary goals of the procedure are to improve restricted cerebrospinal fluid flow and to free up the nerve.
Facet Joint Injections
Background: Research studies as well as therapeutic.
Procedure: Epidurography and epidurolysis can be performed at any level of the spine ranging from the tailbone to the top of the cervical spine. Laboratory studies are generally performed prior to the procedure. The studies might include a complete blood count and clotting (coagulation) studies. The patient is generally placed on a cushioned fluoroscopy table. Special pillows will be used to mount the patient up into the necessary and a comfortable position. A local anesthetic agent is applied. The needle is then incrementally guided into the epidural space. A RACZ catheter, which was designed specifically for this purpose, is put into position. Under image guidance, the catheter is placed into the specific area of pain generating fibrosis. Guiding the catheter tip into an area filled with enlarged or dilated veins and scar tissue can be an extremely challenging task.
Once the target site is identified a contrast medium is injected to demonstrate the speed of contrast injection. This helps determine if there might be a filling defect. Once a steroid and local anesthetic is injected, an approximate 30-minute wait time is utilized to allow for significant sensory and motor blockade. A hypertonic saline solution is then injected under pressure to help breakup scar tissue.
Goals of the procedure: The primary goals of the procedure are to improve restricted cerebrospinal fluid flow and to free up the nerve.
Facet Joint Injections
Background: Research studies as well as therapeutic.
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