Cervical Discography/Disc Access
Abstract Cervical discography was first described in the literature by Ralph Cloward and George Smith in the late 1950s. Cervical provocation discography potentially provides a method to obtain pain-generation data…
Cervical Zygapophysial Joint Nerve (Medial Branch) Injection—Anterolateral Approach: Ultrasound Guidance
Abstract Cervical facet joint nerves (medial branches) can be safely, effectively, and efficiently accessed with ultrasound (US) guidance by an experienced interventionalist.The structures involved are relatively superficial and, thus, lend…
Cervical Zygapophysial Joint Intraarticular Injection, Posterior Approach: Fluoroscopic Guidance
Abstract In this chapter, the posterior approach for injecting the zygapophysial joints (Z-joints) is described. Compared with the lateral approach, the posterior approach allows for access to multiple joint levels…
Stellate Ganglion Injection: Ultrasound Guidance
Abstract For ultrasound (US), a transverse in plane with long-axis confirmation technique at the level of the Chassaignac’s tubercle of C6 is described. By utilizing a hybrid fluoroscopic approach, US…
Cervical Transforaminal Epidural Steroid Injection
Abstract Cervical transforaminal epidural steroid injections are indicated to relieve radicular symptoms with or without axial neck pain from cervical nerve root irritation. The traditional approach to the epidural space…
Cervical Interlaminar Epidural Steroid Injection—Paramedian Approach
Abstract Cervical interlaminar epidural steroid injections are indicated for radicular pain with or without axial neck pain. The interlaminar approach is well suited for delivering medication to bilateral and/or multilevel…
Stellate Ganglion Block: Fluoroscopic Guidance
Abstract Contrast injected at the C6 level has consistently reached the C7-T1 interspace, which is the commonly accepted location of the stellate ganglion. Ideal injectate spread should extend inferiorly to…
Cervical Spinal Cord Stimulation
Abstract Spinal cord stimulation was previously used as a “last resort” for patients who no longer had any other treatment options; however, it should be considered sooner in the treatment…
Thoracic Disc Access
Abstract This chapter describes an extradural oblique technique for efficiently and safely accessing the thoracic disc. As with lumbar discography, the final needle tip target is the geometric center of…
Thoracic Zygapophysial Joint Nerve (Medial Branch) Radiofrequency Neurotomy—Posterior Approach: Fluoroscopic Guidance
Abstract The courses of the C8 and thoracic medial branch nerves are described in the introduction of Chapter 22 and demonstrated in Chapter 22D . A thoracic medial branch nerve…
