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Essentials of Interventional Techniques in Managing Chronic Pain

E-BookPDF1 - PDF WatermarkE-Book
711 Seiten
Englisch
Springer International Publishingerschienen am04.01.20181st ed. 2018
This comprehensive review covers the full and latest array of interventional techniques for managing chronic pain.  Chapters are grouped by specific treatment modalities that include spinal interventional techniques, nonspinal and peripheral nerve blocks, sympathetic interventional techniques, soft tissue and joint injections, and implantables.  Practical step-by-step and evidence-based guidance is given to each approach in order to improve the clinician's understanding.  Innovative and timely, Essentials of Interventional Techniques in Managing Chronic Pain is a critical resource for anesthesiologists, neurologists, and rehabilitation and pain physicians.






Laxmaiah Manchikanti, MD

Chairman of the Board and Chief Executive Officer, ASIPP and SIPMS

Medical Director

Pain Management Center of Paducah
Paducah, Kentucky


Clinical Professor

Anesthesiology and Perioperative Medicine

University of Louisville

Louisville, Kentucky

USA






Alan D. Kaye, MD, PhD

Chairman, Program Director, and Professor
Department of Anesthesia


LSU Health Science Center

New Orleans, Louisiana


USA







Frank J.E. Falco, MD

Medical Director

Mid Atlantic Spine and Pain Physicians

Newark, Delaware

Adjunct Associate Professor

Temple University Medical School

Philadelphia, Pennsylvania



USA




Joshua A. Hirsch, MD

Vice Chief of Interventional Care

Service Line Chief of Interventional Radiology

Director of Interventional Neuroradiology

Chief of NeuroInterventional Spine Service

Massachusetts General Hospital

Harvard Medical School

Boston, Massachusetts



USAmehr

Produkt

KlappentextThis comprehensive review covers the full and latest array of interventional techniques for managing chronic pain.  Chapters are grouped by specific treatment modalities that include spinal interventional techniques, nonspinal and peripheral nerve blocks, sympathetic interventional techniques, soft tissue and joint injections, and implantables.  Practical step-by-step and evidence-based guidance is given to each approach in order to improve the clinician's understanding.  Innovative and timely, Essentials of Interventional Techniques in Managing Chronic Pain is a critical resource for anesthesiologists, neurologists, and rehabilitation and pain physicians.






Laxmaiah Manchikanti, MD

Chairman of the Board and Chief Executive Officer, ASIPP and SIPMS

Medical Director

Pain Management Center of Paducah
Paducah, Kentucky


Clinical Professor

Anesthesiology and Perioperative Medicine

University of Louisville

Louisville, Kentucky

USA






Alan D. Kaye, MD, PhD

Chairman, Program Director, and Professor
Department of Anesthesia


LSU Health Science Center

New Orleans, Louisiana


USA







Frank J.E. Falco, MD

Medical Director

Mid Atlantic Spine and Pain Physicians

Newark, Delaware

Adjunct Associate Professor

Temple University Medical School

Philadelphia, Pennsylvania



USA




Joshua A. Hirsch, MD

Vice Chief of Interventional Care

Service Line Chief of Interventional Radiology

Director of Interventional Neuroradiology

Chief of NeuroInterventional Spine Service

Massachusetts General Hospital

Harvard Medical School

Boston, Massachusetts



USA
Details
Weitere ISBN/GTIN9783319603612
ProduktartE-Book
EinbandartE-Book
FormatPDF
Format Hinweis1 - PDF Watermark
FormatE107
Erscheinungsjahr2018
Erscheinungsdatum04.01.2018
Auflage1st ed. 2018
Seiten711 Seiten
SpracheEnglisch
IllustrationenXXII, 711 p. 932 illus., 319 illus. in color.
Artikel-Nr.2549300
Rubriken
Genre9200

Inhalt/Kritik

Inhaltsverzeichnis
1;Foreword;5
1.1;References;6
2;Foreword;8
2.1;References;10
3;Preface;11
4;Contents;13
5;Contributors;16
6;Part I: Basic Considerations;20
6.1;1: Evolution of Interventional Techniques;21
6.1.1; Introduction;21
6.1.2; History;21
6.1.3; Definitions;22
6.1.4; Development;22
6.1.4.1; Organizations;22
6.1.4.2; Specialty Designation;22
6.1.4.3; Board Certification;22
6.1.5; Accountable Interventional Pain Management;22
6.1.6; Evolving Role;24
6.1.7; Key Points;25
6.1.8;References;31
6.2;2: Chronic Pain: Pathophysiology and Mechanisms;33
6.2.1; Introduction;33
6.2.1.1; Pain Signaling;33
6.2.1.2; Key Terminology;33
6.2.2; Transduction;34
6.2.2.1; Nociceptors;34
6.2.3; Transmission;34
6.2.3.1; Nerve Fibers;34
6.2.4; Modulation;37
6.2.4.1; Peripheral Mechanisms;37
6.2.4.2; Central Spinal Mechanisms;37
6.2.4.3; Central Supraspinal Mechanisms;40
6.2.5; Perception;40
6.2.6; Conclusion;42
6.2.7; Key Points;42
6.2.8;References;42
6.3;3: Pharmacology and Clinical Relevance of Commonly Used Drugs;44
6.3.1; Introduction;44
6.3.2; Local Anesthetics;44
6.3.2.1; Local Anesthetic Groups;44
6.3.2.1.1; Liposomal Bupivacaine;45
6.3.2.2; Interactions with Local Anesthetics;45
6.3.2.2.1; Risks with Local Anesthetic Use;45
6.3.2.3; Local Anesthetic Systematic Toxicity;46
6.3.2.4; Systemic Toxicity Related to Local Anesthetics;46
6.3.2.4.1; Management of Local Anesthetic Systemic Toxicity;46
6.3.3; Corticosteroids;46
6.3.3.1; Compounded Steroids and Fungal Meningitis;48
6.3.4; Contrast Agents;48
6.3.5; Neurolytic Agents;49
6.3.5.1; Alcohol;49
6.3.5.2; Phenol;49
6.3.5.3; Adverse Effects of Neurolytics;49
6.3.6; Key Points;49
6.3.7;References;50
6.4;4: Compliance and Documentation for Interventional Techniques;52
6.4.1; Documentation Requirements;52
6.4.1.1; History and Physical;52
6.4.1.2; Indications and Medical Necessity;53
6.4.1.3; Procedural Documentation;53
6.4.2; Documentation in Ambulatory Surgical Centers (ASCs);53
6.4.2.1; History and Physical Examination;53
6.4.2.2; History;53
6.4.2.3; Physical Examination;54
6.4.2.4; Preoperative Requirements;54
6.4.2.4.1; Preoperative Medical Record Requirements;54
6.4.2.5; Anesthesia Requirements;54
6.4.2.6; Anesthetic Risk and Evaluation;55
6.4.2.7; Intra- and Postoperative Documentation Requirements;55
6.4.2.8; Procedural Documentation;55
6.4.2.9; Discharge/Disposition;55
6.4.3; Documentation for Hospital Outpatient Department;56
6.4.3.1; Informed Consent;56
6.4.3.2; History and Physical Examination;56
6.4.3.3; Monitoring;56
6.4.3.4; Intra- and Postoperative Documentation Requirements;56
6.4.3.5; Procedural Documentation;56
6.4.4; In-Office Documentation;56
6.4.5; Key Points;56
6.4.6;References;56
6.5;5: Sedation for Interventional Techniques;58
6.5.1; Introduction;58
6.5.2; History;58
6.5.3; Medical Necessity;59
6.5.4; Evidence Base;60
6.5.4.1; Diagnostic Interventions;60
6.5.4.2; Therapeutic Interventions;61
6.5.5; Role of Sedation for Interventional Techniques;62
6.5.6; Definitions of Levels of Sedation;63
6.5.7; Considerations for Procedural Sedation;63
6.5.8; Monitoring;63
6.5.8.1; Sedation Depth Monitoring;63
6.5.9; Medications;64
6.5.9.1; Benzodiazepines;64
6.5.9.2; Opioids;64
6.5.9.3; Propofol;64
6.5.9.4; Ketamine;65
6.5.9.5; Dexmedetomidine;66
6.5.9.6; Naloxone (Reversal Agents);66
6.5.9.7; Flumazenil (Reversal Agents);66
6.5.10; Recovery and Discharge;66
6.5.11; Side Effects and Complications;66
6.5.12; Key Points;67
6.5.13;References;67
6.6;6: Antithrombotic and Antiplatelet Therapy;69
6.6.1; Thrombotic Risks with Discontinuation;69
6.6.2; Interventional Pain Management Practice;70
6.6.3; Key Points;73
6.6.4;References;73
7;Part II: Spinal Interventional Techniques;76
7.1;7: Anatomy of the Spine for the Interventionalist;77
7.1.1; Introduction;77
7.1.2; Anatomical Planes;77
7.1.2.1; Spinal Column;77
7.1.2.2; Fluoroscopic Anatomy;82
7.1.2.3; Bony Elements;84
7.1.2.4; Spondylolysis and Spondylolisthesis;84
7.1.3; Ligaments of the Spine;85
7.1.3.1; Cervical Spine;87
7.1.3.2; Thoracic Spine;90
7.1.3.3; Lumbar Spine;90
7.1.3.4; Sacrum;90
7.1.3.5; Spinal Cord and Nerve Roots;94
7.1.3.6; The Spinal Cord and Its Coverings;95
7.1.3.7; Blood Supply to the Spinal Cord;99
7.1.4; Key Points;99
7.1.5;References;102
7.2;8: Radiology of the Spine for the Interventionalist;103
7.2.1; Introduction;103
7.2.2; Imaging Modalities;103
7.2.2.1; Plain X-Rays and Fluoroscopy;103
7.2.2.2; Nuclear Medicine;104
7.2.2.3; Computed Tomography (CT);104
7.2.2.4; Magnetic Resonance Imaging (MRI);104
7.2.2.5; Myelography;105
7.2.3; Degenerative Lumbosacral Spine;105
7.2.3.1; Intervertebral Disc Disease;105
7.2.3.2; Inflammatory Reaction to Intervertebral Disc Disease;106
7.2.3.3; Facet Disease;107
7.2.3.4; Combination: Central Canal Stenosis;107
7.2.3.5; Neural Foraminal Narrowing;109
7.2.3.6; Degenerative Sacroiliac (SI) Joint Disease;109
7.2.3.7; Postoperative Spine;110
7.2.4; Degenerative Thoracic Spine;110
7.2.4.1; Disc Protrusion;110
7.2.4.2; Costochondral Joint Abnormalities;111
7.2.4.3; Kyphosis;111
7.2.5; Degenerative Cervical Spine Disease;112
7.2.5.1; Disc Protrusion;112
7.2.5.2; Disc Extrusion;112
7.2.5.3; Chronic Disc/Osteophyte Complex;113
7.2.5.4; Central Cervical Spinal Canal Stenosis;113
7.2.5.5; Facet Joint Degenerative Disease with Osteophytic Spurring;113
7.2.5.6; Narrowed Neural Foramen from Disc/Osteophyte Complex Affecting the Uncinate Process;113
7.2.6; Traumatic Injuries;114
7.2.7; Infectious Diseases of the Spine and Cord;118
7.2.8; Key Points;120
7.2.9;References;122
7.3;9: Fluoroscopy in Interventional Pain Management;123
7.3.1; Introduction;123
7.3.2; History;123
7.3.3; Technical Aspects;124
7.3.3.1; Fluorescence;124
7.3.3.2; The Fluoroscopic Imaging Chain;126
7.3.3.3; The X-Ray Generator;126
7.3.3.4; The X-Ray Tube;126
7.3.3.5; Image Intensifier;128
7.3.3.6; Collimation;128
7.3.3.7; Optical Coupling;129
7.3.3.8; Analogue to Digital Converter;130
7.3.3.9; Fluoroscopy Table and Pad;130
7.3.3.10; Configuration of Fluoroscopic Systems;130
7.3.4; Radiation Safety;131
7.3.5; Indications and Clinical Applications;134
7.3.6; Precautions;135
7.3.7; Key Points;135
7.3.8;References;136
7.4;10: Needle Manipulation Techniques;138
7.4.1; Introduction;138
7.4.2; Preinjection Setup;138
7.4.2.1; Set Up the Room;138
7.4.2.2; Orient the Fluoroscope;138
7.4.2.3; Position the Patient;139
7.4.2.4; Visualize the Target;141
7.4.2.5; Choose the Skin Insertion Point;141
7.4.2.6; Advance the Needle in Small, Incremental Fashion to the Target;142
7.4.2.7; Local Anesthesia;142
7.4.3; The Art of Needle Placement;142
7.4.3.1; History of Spinal Needles;143
7.4.3.2; Using Tactile Techniques for Needle Placement;143
7.4.3.3; Pearl;144
7.4.3.4; The Loss-of-Resistance Technique;144
7.4.3.5; Pearl;145
7.4.3.6; Using Fluoroscopy for Needle Placement;145
7.4.3.7; Planning Prior to Needle Insertion;145
7.4.3.8; Needle Orientation to the Fluoroscopy Beam;145
7.4.3.9; Needle Density as It Pertains to Visibility;146
7.4.3.10; Pearl;147
7.4.3.11; Tracking Needle Tip Position;147
7.4.3.12; Steering Needles Within the Body;148
7.4.3.13; Specific Types of Needle Bevels;148
7.4.3.14; Steering the Needle;149
7.4.3.15; Needle Hub Rotation;149
7.4.3.16; Needle Hub Notch;150
7.4.3.17; Pearl;150
7.4.3.18; Bending the Needle Shaft;150
7.4.3.19; Needle Shaft Bowing;150
7.4.3.19.1; Bowing the Needle into an Arc Configuration to Facilitate L5/S1 Transforaminal Injection;150
7.4.3.20; Control the Tip of the Needle;151
7.4.3.21; Assuring the Location of the Needle Tip;151
7.4.3.22; Needle Aspiration;151
7.4.3.23; Injection of Contrast;151
7.4.3.24; Injection of Active Medication;151
7.4.4; Key Points;152
7.4.5;References;152
7.5;11: Lumbar Epidural Injections;153
7.5.1;Introduction;153
7.5.2;History;153
7.5.3;Pathophysiology;154
7.5.4;Evidence Base;154
7.5.5;Indications;157
7.5.6;Anatomy;157
7.5.6.1;Epidural Space;159
7.5.6.2;Nerves;161
7.5.6.3;Vasculature;163
7.5.7;Technical Aspects;165
7.5.7.1;Lumbar Interlaminar Epidural Injections;165
7.5.7.2;Extra-epidural Placement;173
7.5.8;Lumbar Transforaminal Epidural Injections;173
7.5.8.1;Critical Anatomy;173
7.5.8.2;Technical Implications;177
7.5.8.3;Safe Triangle Approach;179
7.5.8.4;Inferior or Kambin´s Triangle Approach;179
7.5.8.5;First Sacroiliac Transforaminal;181
7.5.8.6;Extraneural Placement of Needle;184
7.5.9;Caudal Epidural Injections;186
7.5.9.1;Extra-epidural Placement;191
7.5.10;Side Effects and Complications;191
7.5.11;Precautions;192
7.5.12;Key Points;195
7.5.13;References;196
7.6;12: Thoracic Epidural Injections;199
7.6.1; Introduction;199
7.6.2; History;199
7.6.3; Pathophysiology;199
7.6.4; Evidence Base;200
7.6.5; Indications;200
7.6.6; Anatomy;200
7.6.7; Technical Aspects;206
7.6.8; Thoracic Epidural Injections;206
7.6.8.1; Extra-epidural Placement;208
7.6.8.2; Thoracic Transforaminal Epidural Injections;211
7.6.8.3; Critical Anatomy;211
7.6.8.4; Technical Implications;213
7.6.8.5; Supraneural Approach;214
7.6.8.6; Infraneural Approach;214
7.6.9; Side Effects and Complications;216
7.6.10; Precautions;217
7.6.11; Key Points;217
7.6.12;References;218
7.7;13: Cervical Epidural Injections;221
7.7.1; Introduction;221
7.7.2; History;221
7.7.3; Pathophysiology;222
7.7.4; Evidence Base;222
7.7.5; Indications;224
7.7.6; Anatomy;224
7.7.7; Technical Aspects;230
7.7.7.1; Interlaminar Epidural Injections;230
7.7.7.2; Extra-epidural Placement;234
7.7.7.3; Transforaminal Epidural Injections;240
7.7.7.3.1; Critical Anatomic Considerations;241
7.7.7.4; Safety Considerations;243
7.7.7.5; Technique;245
7.7.7.6; Extraneural Placement of Needle;247
7.7.8; Side Effects and Complications;247
7.7.9; Precautions;248
7.7.10; Key Points;249
7.7.11;References;249
7.8;14: Percutaneous Adhesiolysis;253
7.8.1; Introduction;253
7.8.2; History;253
7.8.3; Pathophysiology;254
7.8.4; Evidence Base;255
7.8.5; Rationale;255
7.8.6; Indications;255
7.8.7; Anatomy;257
7.8.8; Technical Aspects;263
7.8.8.1; Racz Technique;267
7.8.8.2; The Caudal Approach;267
7.8.8.3; Interlaminar Lumbar Approach;269
7.8.8.4; Manchikanti Technique;271
7.8.8.5; Myelographic or Subarachnoid Patterns;273
7.8.8.6; Subdural Placement;275
7.8.8.7; Transforaminal Approach;276
7.8.9; Side Effects and Complications;279
7.8.10; Precautions;280
7.8.11; Key Points;281
7.8.12;References;282
7.9;15: Discography;285
7.9.1; Introduction;285
7.9.2; History;285
7.9.3; Pathophysiology;286
7.9.4; Role of Discography;286
7.9.4.1; Rationale;288
7.9.4.2; Validity;288
7.9.5; Evidence Base;288
7.9.6; Indications;289
7.9.7; Anatomy;289
7.9.8; Technical Aspects;289
7.9.8.1; Lumbar Discography;290
7.9.8.1.1; Positioning;290
7.9.8.1.2; Needles;292
7.9.8.1.3; Disc Injection;292
7.9.8.1.4; Post Discography Imaging;294
7.9.8.2; Cervical Discography;294
7.9.8.2.1; Anterior Approach;294
7.9.8.2.2; Anterolateral Approach;298
7.9.8.2.3; Disc Injection;298
7.9.8.2.4; Post Discography CT Imaging;303
7.9.8.3; Thoracic Discography;303
7.9.8.3.1; Disc Entry;303
7.9.8.3.2; Disc Injection;305
7.9.8.3.3; Post Discography CT Imaging;306
7.9.9; Side Effects and Complications;306
7.9.10; Precautions;308
7.9.11; Key Points;309
7.9.12;References;309
7.10;16: Percutaneous Lumbar Thermal Annular Procedures;313
7.10.1; Introduction;313
7.10.2; History;313
7.10.3; Intradiscal Electrothermal Therapy (IDET);314
7.10.4; DiscTRODE;314
7.10.5; Biacuplasty;314
7.10.6; Side Effects and Complications;317
7.10.7; Conclusion;318
7.10.8; Key Points;319
7.10.9;References;319
7.11;17: Lumbar Percutaneous Mechanical Disc Decompression;321
7.11.1; Introduction;321
7.11.2; History;321
7.11.3; Pathophysiology;321
7.11.3.1; Herniated Disc;322
7.11.4; Rationale;324
7.11.5; Evidence Base;325
7.11.6; Indications;326
7.11.7; Anatomy;327
7.11.8; Technical Aspects;332
7.11.8.1; Automated Percutaneous Lumbar Discectomy;335
7.11.8.2; Percutaneous Lumbar Laser Discectomy;338
7.11.8.3; Mechanical High RPM Device or Dekompressor;340
7.11.8.4; Hydrodiscectomy;340
7.11.8.5; Nucleoplasty;344
7.11.8.6; Postoperative Care of Mechanical Disc Decompression Patients;345
7.11.9; Side Effects and Complications;345
7.11.10; Precautions;345
7.11.11; Key Points;346
7.11.12;References;346
7.12;18: Sacroiliac Joint Interventions;349
7.12.1; Introduction;349
7.12.2; History;349
7.12.3; Pathophysiology;349
7.12.4; Evidence Base;351
7.12.5; Indications;351
7.12.6; Diagnosis;351
7.12.6.1; History and Physical Exam;352
7.12.6.2; Diagnostic Sacroiliac Joint Injections;352
7.12.7; Anatomy;352
7.12.7.1; Structure;352
7.12.7.2; Innervation;353
7.12.8; Technical Aspects;353
7.12.8.1; Diagnostic Blocks;353
7.12.8.2; Radiofrequency Techniques;354
7.12.9; Side Effects and Complications;357
7.12.10; Precautions;358
7.12.11; Key Points;358
7.12.12;References;358
7.13;19: Lumbar Facet Joint Interventions;360
7.13.1; Introduction;360
7.13.2; History;360
7.13.3; Pathophysiology;360
7.13.4; Evidence Base;361
7.13.5; Diagnosis of Lumbar Facet Joint Pain;362
7.13.5.1; Diagnostic Facet Joint Nerve Blocks;363
7.13.5.1.1; Principles;363
7.13.5.1.2; Rationale;363
7.13.5.1.3; Validity;364
7.13.5.2; Therapeutic Facet Joint Interventions;364
7.13.6; Indications;364
7.13.7; Anatomy;364
7.13.7.1; Structure;364
7.13.7.2; Innervation;364
7.13.8; Technical Aspects;367
7.13.8.1; Lumbar Facet Joint Intra-articular Injections;367
7.13.8.2; Medial Branch Blocks;368
7.13.8.3; L1-L4 Medial Branch Blocks;370
7.13.8.3.1; Prone Position Oblique;370
7.13.8.3.2; Prone Position Anteroposterior;372
7.13.8.3.3; L5 Dorsal Ramus Blocks;373
7.13.8.4; Radiofrequency Neurotomy;373
7.13.9; Side Effects and Complications;375
7.13.10; Precautions;376
7.13.11; Key Points;377
7.13.12;References;377
7.14;20: Thoracic Facet Joint Interventions;380
7.14.1; Introduction;380
7.14.2; History;380
7.14.3; Pathophysiology;380
7.14.4; Evidence Base;381
7.14.5; Diagnosis of Thoracic Facet Joint Pain;382
7.14.5.1; Diagnostic Facet Joint Nerve Blocks;382
7.14.5.1.1; Principles;382
7.14.5.1.2; Rationale;383
7.14.5.1.3; Validity;383
7.14.5.2; Therapeutic Facet Joint Interventions;383
7.14.6; Indications;383
7.14.7; Anatomy;383
7.14.7.1; Structure;383
7.14.7.2; Features;385
7.14.7.3; Innervation;385
7.14.7.4; Relation to Spinous Processes;387
7.14.7.5; Relation to Vascular Structures;387
7.14.8; Technical Aspects;387
7.14.8.1; Intra-articular Thoracic Facet Joint Injections;389
7.14.8.1.1; Medial Branch Blocks;390
7.14.8.2; Radiofrequency Neurotomy;391
7.14.9; Side Effects and Complications;391
7.14.10; Precautions;393
7.14.11; Key Points;393
7.14.12;References;394
7.15;21: Cervical Facet Joint Interventions;397
7.15.1; Introduction;397
7.15.2; History;397
7.15.3; Pathophysiology;398
7.15.4; Evidence Base;399
7.15.5; Diagnosis of Cervical Facet Joint Pain;399
7.15.5.1; Diagnostic Facet Joint Nerve Blocks;400
7.15.5.1.1; Principles;400
7.15.5.1.2; Rationale;400
7.15.5.1.3; Validity;400
7.15.5.2; Therapeutic Facet Joint Interventions;401
7.15.6; Indications;402
7.15.7; Anatomy;402
7.15.7.1; Structure;402
7.15.7.2; Features;402
7.15.7.3; Innervation;402
7.15.7.4; Relation to Vascular Structures;406
7.15.8; Technical Aspects;406
7.15.8.1; Intra-articular Cervical Facet Joint Injections;406
7.15.8.1.1; Posterior Approach;406
7.15.8.1.2; Lateral Approach;409
7.15.8.1.3; Cervical Medial Branch Blocks;410
7.15.8.1.4; Posterior Approach;412
7.15.8.1.5; Lateral Approach;413
7.15.8.2; Radiofrequency Neurotomy;415
7.15.8.2.1; Conventional Radiofrequency;415
7.15.8.3; Pulsed Mode Radiofrequency;415
7.15.8.4; Typical Cervical Levels;416
7.15.8.5; C7 Medial Branch Neurotomy Technique;417
7.15.8.6; Third Occipital Nerve;418
7.15.9; Precautions;418
7.15.10; Side Effects and Complications;419
7.15.11; Key Points;419
7.15.12;References;420
7.16;22: Atlanto-Occipital and Atlanto-Axial Joint Injections;423
7.16.1; Introduction;423
7.16.2; History;423
7.16.3; Pathophysiology;423
7.16.4; Evidence Base;424
7.16.4.1; Atlanto-Axial Joint Injection;424
7.16.5; Diagnosis;424
7.16.5.1; Physical Examination;425
7.16.6; Anatomy;425
7.16.6.1; Nerves;426
7.16.6.2; The Vertebral Artery;426
7.16.7; Technical Aspects;427
7.16.7.1; Atlanto-Occipital Injection Under Fluoroscopic Guidance;427
7.16.8; Atlanto-Occipital: Ultrasound-Guided Technique;427
7.16.8.1; Atlanto-Axial Injection Under Fluoroscopic Guidance;428
7.16.8.2; Atlanto-Axial: Ultrasound-Guided Technique;429
7.16.9; Precautions;430
7.16.10; Side Effects and Complications;430
7.16.11; Key Points;430
7.16.12;References;431
7.17;23: Percutaneous Image-Guided Lumbar Decompression;432
7.17.1; Introduction;432
7.17.2; History;432
7.17.3; Pathophysiology;433
7.17.4; Evidence Base;433
7.17.5; Rationale;434
7.17.6; Indications;434
7.17.7; Anatomy;434
7.17.8; Technical Aspects;436
7.17.9; Precautions;437
7.17.10; Side Effects and Complications;438
7.17.11; Key Points;439
7.17.12;References;439
7.18;24: Vertebroplasty, Kyphoplasty, and Sacroplasty;440
7.18.1; Introduction;440
7.18.2; History;440
7.18.3; Pathophysiology;440
7.18.4; Evidence Base;441
7.18.5; Indications;441
7.18.6; Diagnosis/Pre-procedural Workup;441
7.18.7; Anatomy;444
7.18.8; Technical Aspects;444
7.18.8.1; Vertebroplasty and Kyphoplasty;444
7.18.8.1.1; Pre-procedure;444
7.18.8.1.2; Procedure;444
7.18.8.2; Sacroplasty;447
7.18.8.2.1; Pre-procedure;447
7.18.8.3; Procedure;447
7.18.8.4; Post-procedure and Follow-Up Care;449
7.18.9; Side Effects and Complications;449
7.18.10; Precautions;449
7.18.11; Key Points;450
7.18.12;References;450
8;Part III: Nonspinal and Peripheral Nerve Blocks;452
8.1;25: Ultrasound Basics;453
8.1.1; Introduction;453
8.1.1.1; Principles of Ultrasound;453
8.1.1.2; Basic Concepts of Ultrasound Imaging;456
8.1.1.3; Knobology: Understanding Your Machine;456
8.1.2; Key Points;457
8.1.3;References;457
8.2;26: Trigeminal Nerve Blocks and Neurolysis;459
8.2.1; Introduction;459
8.2.2; History;459
8.2.3; Pathophysiology;459
8.2.4; Diagnosis;461
8.2.5; Evidence Base;461
8.2.6; Anatomy;461
8.2.7; Technical Aspects;462
8.2.7.1; Percutaneous Trigeminal Ganglion Procedures;462
8.2.7.2; Trigeminal Ganglion Block or Neurolysis;463
8.2.7.3; Other Approaches to Trigeminal Ganglion Neurolysis;465
8.2.7.4; Block of the Maxillary and Mandibular Nerves;465
8.2.7.5; Block of the Terminal Sensory Branches of the Trigeminal Nerve;465
8.2.8; Side Effects and Complications;467
8.2.9; Precautions;467
8.2.10; Key Points;467
8.2.11;References;468
8.3;27: Occipital Nerve Blocks and Neurolysis;470
8.3.1; Introduction;470
8.3.2; History;470
8.3.3; Pathophysiology;470
8.3.3.1; Symptoms;471
8.3.3.2; Diagnosis;471
8.3.3.3; Differential Diagnosis Includes Possible Sources of Pain;471
8.3.4; Evidence Base;471
8.3.4.1; Contraindications [36];472
8.3.5; Indications;472
8.3.6; Anatomy;472
8.3.7; Technical Aspects;473
8.3.8; Precautions;475
8.3.9; Side Effects and Complications;475
8.3.10; Key Points;476
8.3.11;References;476
8.4;28: Suprascapular Nerve Blocks and Neurolysis;478
8.4.1; Introduction;478
8.4.2; History;478
8.4.3; Pathophysiology;478
8.4.4; Evidence Base;479
8.4.4.1; Chronic Pain;479
8.4.4.2; Acute Pain;479
8.4.5; Indications;479
8.4.6; Anatomy;479
8.4.7; Technical Aspects;480
8.4.7.1; Blind Technique;481
8.4.7.2; Direct Approach;481
8.4.7.3; Superior Approach;481
8.4.7.4; Posterior Approach;481
8.4.7.5; Anterior Approach;481
8.4.7.6; Posteromedial Approach;481
8.4.7.7; Radiographic Technique;481
8.4.7.8; Ultrasound Technique;482
8.4.7.9; Suprascapular Neurolysis;484
8.4.8; Precautions;485
8.4.9; Side Effects and Complications;485
8.4.10; Key Points;485
8.4.11;References;485
8.5;29: Chest Wall Blocks and Neurolysis;487
8.5.1; Introduction;487
8.5.2; History;487
8.5.3; Pathophysiology;487
8.5.4; Evidence Base;488
8.5.5; Diagnosis;488
8.5.6; Anatomy;488
8.5.7; Interventional Technique;489
8.5.7.1; Blind Intercostal Nerve Blocks;489
8.5.7.2; Medications;490
8.5.7.3; Ultrasound-Guided Intercostal Nerve Blocks;490
8.5.7.4; Fluoroscopically Guided Intercostal Nerve Blocks;491
8.5.7.5; Radiofrequency Ablation of Intercostal Nerves;491
8.5.7.6; Intercostal Chemical Neurolysis;492
8.5.8; Precautions;492
8.5.9; Side Effects and Complications;492
8.5.10; Key Points;493
8.5.11;References;493
8.6;30: Abdominal Wall Blocks and Neurolysis;495
8.6.1; Introduction;495
8.6.2; Transversus Abdominal Plane Block;495
8.6.2.1; Applications;495
8.6.2.2; Anatomy;495
8.6.2.3; Technical Aspects;496
8.6.2.4; Precautions;496
8.6.3; Rectus Sheath Block;496
8.6.3.1; Indications;497
8.6.3.2; Anatomy;497
8.6.3.3; Technical Aspects;497
8.6.3.4; Precautions;498
8.6.4; Paravertebral Block;498
8.6.4.1; Anatomy;498
8.6.4.2; Technical Aspects;498
8.6.4.3; Precautions;499
8.6.5; Ilioinguinal and Iliohypogastric Nerve Block;500
8.6.5.1; Anatomy;500
8.6.5.2; Technical Aspects;500
8.6.5.3; Precautions;501
8.6.6; Conclusion;501
8.6.7; Key Points;501
8.6.8;References;502
8.7;31: Upper Extremity Nerve Blocks and Neurolysis;503
8.7.1; Introduction;503
8.7.2; Brachial Plexus Block;503
8.7.2.1; History;503
8.7.2.2; Pathophysiology;503
8.7.2.3; Evidence Base;503
8.7.2.4; Anatomy;503
8.7.2.5; Technical Aspects;504
8.7.2.5.1; Interscalene BP Block;504
8.7.2.5.2; Supraclavicular BP Block;505
8.7.2.5.3; Infraclavicular BP Block;505
8.7.2.6; Precautions;505
8.7.2.7; Side Effects and Complications;505
8.7.3; Axillary Nerve Block;505
8.7.3.1; History;505
8.7.3.2; Pathophysiology;505
8.7.3.3; Evidence Base;505
8.7.3.4; Diagnosis;505
8.7.3.5; Anatomy;505
8.7.3.6; Physical Examination and Testing;505
8.7.3.7; Technical Aspects;506
8.7.3.7.1; Ultrasound-Guided Injection;506
8.7.3.8; Precautions;506
8.7.3.9; Side Effects and Complications;506
8.7.4; Radial Nerve Block;506
8.7.4.1; History;506
8.7.4.2; Pathophysiology;506
8.7.4.3; Diagnosis;506
8.7.4.4; Physical Examination;507
8.7.4.5; Anatomy;507
8.7.4.6; Technical Aspects;508
8.7.4.6.1; Radial Tunnel Injection;508
8.7.4.6.1.1;Blind Technique;508
8.7.4.6.1.2;Ultrasound-Guided Technique;508
8.7.4.6.2; Superficial Radial Nerve at Wrist;508
8.7.4.6.2.1;Blind Injection Technique;508
8.7.4.6.2.2;Ultrasound Guidance;508
8.7.4.6.2.3;Neurolysis;508
8.7.4.7; Precautions;508
8.7.4.8; Side Effects and Complications;508
8.7.5; Median Nerve Block;508
8.7.5.1; History;508
8.7.5.2; Pathophysiology;508
8.7.5.3; Evidence Base;508
8.7.5.4; Diagnosis;508
8.7.5.5; Physical Examination;509
8.7.5.6; Diagnostic Testing;509
8.7.5.7; Anatomy;509
8.7.5.8; Technical Aspects;509
8.7.5.8.1; Blind Technique;509
8.7.5.8.2; Ultrasound Guidance;509
8.7.5.8.3; Neurolysis;510
8.7.5.9; Precautions;510
8.7.5.10; Side Effects and Complications;510
8.7.6; Ulnar Nerve Block;510
8.7.6.1; History;510
8.7.6.2; Pathophysiology;510
8.7.6.3; Evidence Base;510
8.7.6.4; Diagnosis;510
8.7.6.5; Physical Examination;510
8.7.6.6; Anatomy;511
8.7.6.7; Technical Aspects;511
8.7.6.7.1; Blind Injections;511
8.7.6.7.2; Ultrasound Guidance;511
8.7.6.8; Precautions;511
8.7.6.9; Side Effects and Complications;511
8.7.7; Key Points;511
8.7.8;References;511
8.8;32: Lower Extremity Nerve Blocks and Neurolysis;514
8.8.1; Introduction;514
8.8.2; Genitofemoral Nerve Blocks;514
8.8.2.1; History;514
8.8.2.2; Pathophysiology;514
8.8.2.3; Evidence Base;514
8.8.2.4; Diagnosis;514
8.8.2.4.1; Differential Diagnosis;515
8.8.2.5; Anatomy;515
8.8.2.6; Technical Aspects;515
8.8.2.6.1; Blind Technique;515
8.8.2.6.2; Fluoroscopic Guidance;515
8.8.2.6.3; Ultrasound Guidance;515
8.8.2.6.4; CT Guidance;515
8.8.2.6.5; Neurolysis;515
8.8.3; Lateral Femoral Cutaneous Nerve Blocks;515
8.8.3.1; History;515
8.8.3.2; Pathophysiology;516
8.8.3.3; Evidence Base;516
8.8.3.4; Diagnosis;516
8.8.3.4.1; Differential Diagnosis;516
8.8.3.5; Anatomy;516
8.8.3.6; Technical Aspects;516
8.8.3.6.1; Blind Technique;516
8.8.3.6.2; Ultrasound Guidance;516
8.8.3.6.3; Neurolysis;516
8.8.4; Obturator Nerve Block;517
8.8.4.1; History;517
8.8.4.2; Pathophysiology;517
8.8.4.3; Evidence Base;517
8.8.4.4; Diagnosis;517
8.8.4.4.1; Physical Examination;517
8.8.4.4.2; Anatomy;517
8.8.4.5; Technical Aspects;517
8.8.4.5.1; Blind Technique;517
8.8.4.5.2; Fluoroscopic Guidance;517
8.8.4.5.3; Ultrasound Guidance;517
8.8.4.5.4; Neurolysis;518
8.8.5; Common Peroneal Nerve Block;518
8.8.5.1; History;518
8.8.5.2; Pathophysiology;518
8.8.5.3; Diagnosis;518
8.8.5.4; Anatomy;518
8.8.5.5; Technical Aspects;518
8.8.5.5.1; Blind Technique;518
8.8.5.5.2; Ultrasound Guided;518
8.8.6; Tarsal Tunnel Injection;518
8.8.6.1; History;518
8.8.6.2; Pathophysiology;518
8.8.6.3; Diagnosis;519
8.8.6.3.1; Differential Diagnosis;519
8.8.6.4; Anatomy;519
8.8.6.5; Technical Aspects;519
8.8.6.5.1; Blind Technique;519
8.8.6.5.2; Ultrasound Guided;519
8.8.7; Digital Blocks of the Foot for Interdigital Neuritis (Morton´s Neuroma);519
8.8.7.1; History;519
8.8.7.2; Pathophysiology;519
8.8.7.3; Diagnosis;520
8.8.7.3.1; Anatomy;520
8.8.7.4; Technical Aspects;520
8.8.7.4.1; Blind Technique;520
8.8.7.4.2; Ultrasound Guidance;520
8.8.8; Side Effects and Complications;520
8.8.9; Key Points;520
8.8.10;References;520
9;Part IV: Sympathetic Interventional Techniques;522
9.1;33: Sphenopalatine Ganglion Blocks;523
9.1.1; Introduction;523
9.1.2; History;523
9.1.3; Evidence Base;523
9.1.4; Indications;525
9.1.4.1; Preoperative Evaluation;525
9.1.5; Anatomy;526
9.1.6; Technical Aspects;527
9.1.6.1; Intranasal Approach;527
9.1.6.2; Infrazygomatic Approach;527
9.1.6.3; Transnasal Approach;529
9.1.6.4; Radiofrequency Lesioning;531
9.1.7; Precautions;532
9.1.8; Side Effects and Complications;532
9.1.9; Key Points;532
9.1.10;References;532
9.2;34: Cervical and Thoracic Sympathetic Blocks;534
9.2.1; Introduction;534
9.2.2; History;534
9.2.3; Pathophysiology;535
9.2.4; Evidence Base;536
9.2.4.1; Local Anesthetic Blocks;537
9.2.5; Indications;537
9.2.6; Diagnosis;538
9.2.7; Anatomy;539
9.2.8; Technical Aspects;541
9.2.8.1; Stellate Ganglion Block;542
9.2.8.2; Classic Anterior Approach;544
9.2.8.3; Modified Oblique Technique;547
9.2.8.4; Upper Thoracic Sympathetic Block;548
9.2.8.5; Neurolytic Procedures;549
9.2.8.6; Clinical Signs of Successful Stellate Ganglion Block;549
9.2.9; Precautions;550
9.2.10; Side Effects and Complications;550
9.2.11; Key Points;551
9.2.12;References;551
9.3;35: Lumbar Sympathetic Block and Neurolysis;554
9.3.1; Introduction;554
9.3.2; History;554
9.3.3; Pathophysiology;554
9.3.4; Indications;555
9.3.5; Evidence Base;555
9.3.6; Anatomy;555
9.3.7; Technical Aspects;558
9.3.7.1; Anatomic Variations;558
9.3.7.2; Technique;558
9.3.7.3; Approaches to Lumbar Sympathetic Block;559
9.3.7.4; Paramedian (Classic Mandl´s) Approach;559
9.3.7.5; Lateral (Reid´s) Approach;559
9.3.7.6; Transdiscal Lumbar Sympathetic Block;562
9.3.7.7; Paradiscal Extraforaminal Technique;564
9.3.7.8; Chemical Neurolytic Block;568
9.3.7.9; RF Lesioning;568
9.3.7.10; Sluijter´s Technique;569
9.3.7.11; Gauci´s Technique;571
9.3.8; Side Effects and Complications;572
9.3.9; Key Points;573
9.3.10;References;573
9.4;36: Hypogastric Plexus Blocks;575
9.4.1; Introduction;575
9.4.2; History;575
9.4.3; Pathophysiology;575
9.4.4; Diagnosis;576
9.4.5; Evidence Base;576
9.4.6; Indications;576
9.4.7; Anatomy;576
9.4.8; Technical Aspects;578
9.4.8.1; Classic Superior Hypogastric Block;578
9.4.8.1.1; Precautions, Side Effects, and Complications;579
9.4.8.2; Transdiscal Superior Hypogastric Block;579
9.4.8.2.1; Precautions, Side Effects, and Complications;579
9.4.8.3; Transsacral Inferior Hypogastric Block;579
9.4.8.3.1; Precautions, Side Effects, and Complications;580
9.4.8.4; Alternate Techniques;580
9.4.8.4.1; Precautions, Side Effects, and Complications;582
9.4.9; Key Points;582
9.4.10;References;582
9.5;37: Ganglion Impar Blockade;583
9.5.1; Introduction;583
9.5.2; History;583
9.5.3; Pathophysiology;583
9.5.4; Evidence Base;583
9.5.5; Indications;584
9.5.6; Anatomy;584
9.5.7; Technical Aspects;584
9.5.7.1; Original Technique;586
9.5.7.2; Modified Needle-Inside-Needle Technique;588
9.5.7.3; Trans-sacral Technique;588
9.5.7.4; Position Confirmation;588
9.5.7.5; Neurolysis;590
9.5.7.6; Thermocoagulation: A Modified Approach;591
9.5.7.7; Landmarks and Needle Positioning;591
9.5.7.8; Magnetic Resonance Neurography;593
9.5.7.9; Cryoablation;593
9.5.7.10; The Paramedian Approach;594
9.5.7.11; The Direct Approach;594
9.5.7.12; Thermocoagulation;594
9.5.7.13; Radiofrequency Ablation: Needle-in-Needle Technique;595
9.5.8; Precautions;595
9.5.9; Side Effects and Complications;595
9.5.10; Key Points;595
9.5.11;References;596
9.6;38: Celiac Plexus Blocks and Splanchnic Nerve Blocks;597
9.6.1; Introduction;597
9.6.2; History;597
9.6.3; Pathophysiology;598
9.6.4; Evidence Base;598
9.6.5; Indications;598
9.6.6; Anatomy;598
9.6.7; Technical Aspects;602
9.6.7.1; Celiac Plexus Blockade;602
9.6.7.2; Splanchnic Nerve Blocks;605
9.6.7.3; Neurolysis;605
9.6.8; Precautions;607
9.6.9; Side Effects and Complications;607
9.6.10; Key Points;607
9.6.11;References;608
10;Part V: Soft Tissue and Joint Injections;610
10.1;39: Trigger Point Injections;611
10.1.1; Introduction;611
10.1.2; History;611
10.1.3; Pathophysiology;612
10.1.4; Evidence Base;612
10.1.5; Diagnosis;612
10.1.6; Trigger Point Injections;613
10.1.6.1; Mechanism of Action;613
10.1.7; Technical Considerations;613
10.1.7.1; Injection Procedure;613
10.1.8; Precautions;614
10.1.9; Side Effects and Complications;614
10.1.10; Key Points;615
10.1.11;References;615
10.2;40: Tendon Insertion, Tendon Sheath, and Bursa Injections;617
10.2.1; Introduction;617
10.2.2; Upper Extremity Injections;617
10.2.2.1; Subacromial-Subdeltoid Bursa;617
10.2.2.1.1; History;617
10.2.2.1.2; Pathophysiology;617
10.2.2.1.3; Evidence Base;617
10.2.2.1.4; Diagnosis;618
10.2.2.1.5; Anatomy;618
10.2.2.1.6; Ultrasound-Guided Injection Technique;618
10.2.2.2; Biceps Tendon Sheath;618
10.2.2.2.1; History;618
10.2.2.2.2; Pathophysiology;618
10.2.2.2.3; Evidence Base;619
10.2.2.2.4; Diagnosis;619
10.2.2.2.5; Anatomy;619
10.2.2.2.6; Ultrasound-Guided Injection Technique;619
10.2.2.3; De Quervain´s Tenosynovitis;620
10.2.2.3.1; History;620
10.2.2.3.2; Pathophysiology;620
10.2.2.3.3; Diagnosis;620
10.2.2.3.4; Evidence Base;620
10.2.2.3.5; Anatomy;620
10.2.2.3.6; Ultrasound-Guided Injection Technique;620
10.2.3; Lower Extremity Injections;621
10.2.3.1; Iliopsoas Bursa;621
10.2.3.1.1; History;621
10.2.3.1.2; Pathophysiology;621
10.2.3.1.3; Evidence Base;621
10.2.3.1.4; Diagnosis;621
10.2.3.1.5; Anatomy;621
10.2.3.1.6; Ultrasound-Guided Injection Technique;621
10.2.3.2; Greater Trochanteric Bursa (Greater Trochanteric Pain Syndrome);622
10.2.3.2.1; History;622
10.2.3.2.2; Pathophysiology;622
10.2.3.2.3; Evidence Base;622
10.2.3.2.4; Diagnosis;622
10.2.3.2.5; Anatomy;622
10.2.3.2.6; Ultrasound-Guided Injection Technique;622
10.2.3.3; Pes Anserine Bursitis;623
10.2.3.3.1; History;623
10.2.3.3.2; Pathophysiology;623
10.2.3.3.3; Evidence Base;623
10.2.3.3.4; Diagnosis;623
10.2.3.3.5; Anatomy;623
10.2.3.3.6; Ultrasound-Guided Injection Technique;623
10.2.3.4; Retrocalcaneal Bursitis;624
10.2.3.4.1; History;624
10.2.3.4.2; Pathophysiology;624
10.2.3.4.3; Evidence Base;624
10.2.3.4.4; Diagnosis;624
10.2.3.4.5; Anatomy;624
10.2.3.4.6; Ultrasound-Guided Injection Technique;624
10.2.4; Side Effects and Complications;625
10.2.5; Precautions;625
10.2.6; Key Points;625
10.2.7;References;625
10.3;41: Botulinum Toxin Injections for Chronic Pain;628
10.3.1; Introduction;628
10.3.2; History;628
10.3.3; Physiology and Pharmacology;628
10.3.3.1; Migraine;629
10.3.3.2; Arthritis;629
10.3.3.3; Myofascial Pain Syndrome;630
10.3.3.4; Trigeminal Neuralgia;630
10.3.3.5; Other Pain Syndromes;631
10.3.3.6; Conclusion;631
10.3.4; Key Points;631
10.3.5;References;631
10.4;42: Upper Extremity Joint Injections;633
10.4.1; Introduction;633
10.4.1.1; General Technique;633
10.4.1.2; Needle and Syringe Size;633
10.4.1.3; Sterile Preparation;633
10.4.1.4; Local Anesthesia;633
10.4.1.5; Glucocorticoid Injection;634
10.4.1.6; Complications;634
10.4.1.6.1; Noninfectious Complication;634
10.4.1.6.2; Infectious Complication;634
10.4.2; Shoulder Injection;634
10.4.2.1; Introduction;634
10.4.2.2; Pathophysiology;635
10.4.2.3; Evidence Base;635
10.4.3; Acromioclavicular Joint;635
10.4.3.1; Indications and Diagnosis;635
10.4.3.2; Interventional Technical Aspects;635
10.4.3.3; Ultrasound-Guided Acromioclavicular Joint Injection;635
10.4.4; Glenohumeral Joint;636
10.4.4.1; Indications;636
10.4.4.2; Interventional Technical Aspects;636
10.4.4.2.1; Landmark Approach;636
10.4.4.2.2; Anterior Approach;637
10.4.4.2.3; Posterior Approach;637
10.4.4.3; Fluoroscopic-Guided Glenohumeral Joint Injection;637
10.4.4.4; Ultrasound-Guided Glenohumeral Joint Injection;637
10.4.5; Elbow Joint;637
10.4.5.1; Introduction;637
10.4.5.2; Pathophysiology;637
10.4.5.3; Evidence Base;637
10.4.5.4; Indications and Diagnosis;638
10.4.5.5; Interventional Technical Aspects;638
10.4.6; Carpal Tunnel;639
10.4.6.1; Introduction;639
10.4.6.2; Pathophysiology;639
10.4.6.3; Evidence Base;639
10.4.6.4; Indications and Diagnosis;639
10.4.6.5; Interventional Technical Aspects;639
10.4.6.6; Ultrasound-Guided Carpal Tunnel Injection;639
10.4.7; Precautions;639
10.4.8; Key Points;640
10.4.9;References;641
10.5;43: Lower Extremity Joint Injections;642
10.5.1; Introduction;642
10.5.2; Femoroacetabular Joint Injection (Hip Joint);642
10.5.2.1; Introduction;642
10.5.2.2; History;642
10.5.2.3; Pathophysiology;642
10.5.2.4; Evidence Base;643
10.5.2.5; Diagnosis;643
10.5.2.6; Relevant Anatomy;643
10.5.2.7; Muscle;643
10.5.2.8; Neurovasculature;643
10.5.2.9; Interventional Technical Aspects;644
10.5.2.10; Preparation;644
10.5.2.11; Fluoroscopy;644
10.5.2.12; Ultrasound;644
10.5.2.13; Side Effects and Complications;644
10.5.3; Knee Joint (Femoral Tibial Joint) Injection;646
10.5.3.1; Introduction;646
10.5.3.2; History;646
10.5.3.3; Pathophysiology;646
10.5.3.4; Evidence Base;646
10.5.3.5; Diagnosis;646
10.5.3.6; Relevant Anatomy [39];647
10.5.3.7; Interventional Technical Aspects [19, 40];647
10.5.3.8; Preparation;647
10.5.3.9; Fluoroscopy;647
10.5.3.10; Ultrasound;647
10.5.3.11; Side Effects and Complications;648
10.5.4; Tibiotalar Joint (Ankle);648
10.5.4.1; Introduction;648
10.5.4.2; History;648
10.5.4.3; Pathophysiology;648
10.5.4.4; Diagnosis;649
10.5.4.5; Evidence Base;649
10.5.4.6; Relevant Anatomy [18];649
10.5.4.7; Muscles/Tendons/Ligaments;649
10.5.4.8; Neurovasculature;649
10.5.4.9; Interventional Technical Aspects;649
10.5.4.10; Preparation;649
10.5.4.11; Fluoroscopy Guided;650
10.5.4.12; Lateral Mortise [49, 57];650
10.5.4.13; Ultrasound;650
10.5.4.14; Side Effects and Complications;651
10.5.5; Key Points;651
10.5.6;References;651
11;Part VI: Implantables;653
11.1;44: Spinal Cord Stimulation;654
11.1.1; Introduction;654
11.1.2; History;654
11.1.3; Pathophysiology;655
11.1.4; Evidence Base;655
11.1.5; Rationale;656
11.1.6; Indications;657
11.1.7; Anatomy;657
11.1.8; Technical Aspects;658
11.1.8.1; The Spinal Cord Stimulator Trial;660
11.1.8.2; Lead Placement Technique;660
11.1.9; Side Effects and Complications;662
11.1.10; Precautions;662
11.1.11; Key Points;663
11.1.12;References;663
11.2;45: Intrathecal Drug Delivery Systems;666
11.2.1; Introduction;666
11.2.2; History;666
11.2.3; Indications;667
11.2.4; Anatomy;667
11.2.5; Intrathecal Pumps;668
11.2.6; Technical Aspects;669
11.2.6.1; Psychological Evaluation;669
11.2.6.2; Trialing;671
11.2.6.3; Permanent Implant;671
11.2.6.4; Abdominal Incision;672
11.2.7; Drugs;673
11.2.8; Side Effects and Complications;673
11.2.8.1; Granuloma;674
11.2.9; Precautions;674
11.2.10; Key Points;674
11.2.11;References;675
11.3;46: Peripheral Nerve Stimulation;677
11.3.1; Introduction;677
11.3.2; History;677
11.3.3; Pathophysiology;677
11.3.4; Evidence Base;678
11.3.5; Rationale;679
11.3.6; Indications;680
11.3.7; Anatomy;680
11.3.8; Technical Aspects;681
11.3.8.1; Occipital Nerve Stimulation (ONS);682
11.3.8.1.1; Anatomy;682
11.3.8.1.2; Technical Aspects;682
11.3.8.1.3; Description of the ONS Procedure;682
11.3.8.1.4; ONS Complications;683
11.3.8.2; Trigeminal Nerve Stimulation (TNS);683
11.3.8.2.1; Stimulation of the Peripheral Branches of the Trigeminal Nerve;684
11.3.8.3; Interstitial Cystitis (IC);684
11.3.9; Side Effects and Complications;685
11.3.10; Precautions;685
11.3.11; Key Points;686
11.3.12;References;687
12;Index;690mehr

Autor

Laxmaiah Manchikanti, MD

Chairman of the Board and Chief Executive Officer, ASIPP and SIPMS

Medical Director

Pain Management Center of Paducah
Paducah, Kentucky


Clinical Professor

Anesthesiology and Perioperative Medicine

University of Louisville

Louisville, Kentucky

USA





Alan D. Kaye, MD, PhD

Chairman, Program Director, and Professor
Department of Anesthesia


LSU Health Science Center

New Orleans, Louisiana


USA






Frank J.E. Falco, MD

Medical Director

Mid Atlantic Spine and Pain Physicians

Newark, Delaware

Adjunct Associate Professor

Temple University Medical School

Philadelphia, Pennsylvania



USA



Joshua A. Hirsch, MD

Vice Chief of Interventional Care

Service Line Chief of Interventional Radiology

Director of Interventional Neuroradiology

Chief of NeuroInterventional Spine Service

Massachusetts General Hospital

Harvard Medical School

Boston, Massachusetts



USA