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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 for Procedure: Indications for sympathetic block include unremitting progressive pain unresponsive to more conservative forms of care. It should be considering when there is phantom lower extremity limb pain, lower extremity pain from vascular insufficiency, lower extremity pain from getting frostbite and reflex sympathetic dystrophy involving the lower extremities.
Goals of The Procedure: The primary goals of the procedure are to normalize blood flow regulation and to reduce sympathetically maintained pain.
Sacroiliac Joint Injection
Background: Sacroiliac joint dysfunction or disease of the sacroiliac joint is felt to be a significant source of low back pain as well as a source of referred pain into the lower extremities. One study reported that as many as 22% of patients with low back pain are symptomatic as a result of sacroiliac joint disease. The pain, which arises from the sacroiliac joint, is felt to be secondary to abnormal movement or misalignment of the joint itself. It may also result from a variety of disorders including degenerative arthritis, fractures, and ligamentous injury.
The pattern of pain, which arises from the sacroiliac joint, is variable, and therefore it can be extremely difficult to distinguish SI pain from other causes of low back pain. More common associated signs and symptoms include low back pain, buttock pain, groin pain, and lower abdominal pain as well as pain radiating into the leg or foot. There is often localizing pain or tenderness over the involved sacroiliac joint. The complex pattern of referred pain can be explained by the patterns of nerve connections to the joint. The sacroiliac joint and the ligaments that surround the joint contain countless specialized nerves that conduct sensation including pain. The front and back aspects of the joint are connected to many nerve fibers, which arise from multiple levels of the spine.
Usually, the diagnosis of SI pain is one of exclusion. Other causes of pain such as spinal stenosis, degenerative disc disease, herniated disc, and facet pain must be excluded. The presence of active inflammation of the sacroiliac joint can sometimes be confirmed by advanced imaging such as computerized tomography and magnetic resonance imaging. CT can be used to adequately evaluate bony changes such as bone spurs, cysts, and various types of degeneration and erosion of the sacroiliac joint surfaces. A nuclear bone scan can also be helpful, although the positive findings sometimes correlate poorly with sacroiliac joint symptoms. Magnetic resonance imaging allows for extremely detailed evaluation of the sacroiliac joint as well as the adjacent supportive and non-supportive soft tissue elements. Injection of a sacroiliac joint can be a diagnostic as well as therapeutic procedure. The injection can be placed under fluoroscopic CT or MRI guidance to improve the accuracy of an injection.
Goals of The Procedure: The primary goals of the procedure are to normalize blood flow regulation and to reduce sympathetically maintained pain.
Sacroiliac Joint Injection
Background: Sacroiliac joint dysfunction or disease of the sacroiliac joint is felt to be a significant source of low back pain as well as a source of referred pain into the lower extremities. One study reported that as many as 22% of patients with low back pain are symptomatic as a result of sacroiliac joint disease. The pain, which arises from the sacroiliac joint, is felt to be secondary to abnormal movement or misalignment of the joint itself. It may also result from a variety of disorders including degenerative arthritis, fractures, and ligamentous injury.
The pattern of pain, which arises from the sacroiliac joint, is variable, and therefore it can be extremely difficult to distinguish SI pain from other causes of low back pain. More common associated signs and symptoms include low back pain, buttock pain, groin pain, and lower abdominal pain as well as pain radiating into the leg or foot. There is often localizing pain or tenderness over the involved sacroiliac joint. The complex pattern of referred pain can be explained by the patterns of nerve connections to the joint. The sacroiliac joint and the ligaments that surround the joint contain countless specialized nerves that conduct sensation including pain. The front and back aspects of the joint are connected to many nerve fibers, which arise from multiple levels of the spine.
Usually, the diagnosis of SI pain is one of exclusion. Other causes of pain such as spinal stenosis, degenerative disc disease, herniated disc, and facet pain must be excluded. The presence of active inflammation of the sacroiliac joint can sometimes be confirmed by advanced imaging such as computerized tomography and magnetic resonance imaging. CT can be used to adequately evaluate bony changes such as bone spurs, cysts, and various types of degeneration and erosion of the sacroiliac joint surfaces. A nuclear bone scan can also be helpful, although the positive findings sometimes correlate poorly with sacroiliac joint symptoms. Magnetic resonance imaging allows for extremely detailed evaluation of the sacroiliac joint as well as the adjacent supportive and non-supportive soft tissue elements. Injection of a sacroiliac joint can be a diagnostic as well as therapeutic procedure. The injection can be placed under fluoroscopic CT or MRI guidance to improve the accuracy of an injection.
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