Abstract Thoracic zygapophysial (facet) joint injections are performed by entering the zygapophysial joint at the inferior aspect of the joint. A substantial caudad tilt of the fluoroscope is required to…
Abstract Unlike fluoroscopy, ultrasound guidance has a true “safety view” because ultrasound can be used to image the intercostal space in real time, while avoiding the underlying pleura. In addition,…
Abstract Although thoracic epidural injections are uncommon, they are indicated for radicular symptoms with or without axial pain, resulting from thoracic spine. The transforaminal approach offers medication delivery to specific…
Abstract Thoracic interlaminar epidural steroid injections are indicated more commonly for radiculopathy caused by a disc protrusion or stenosis of the central canal, intervertebral foramen, or lateral recess. These injections…
Abstract This chapter describes strategies to enter the L5-S1 disc, which requires a modified technique, and delineates the “tricks” to approach the L5-S1 disc when the posterior iliac crest makes…
Abstract This chapter describes and demonstrates strategies to utilize anteroposterior (AP) and lateral imaging to optimally drive the needle tip to a lumbar disc’s central target. It also includes additional…
Abstract Spinal cord (SC) stimulation is generally used as a last resort for patients who no longer have other treatment options. Typically, stimulators are used for patients who have undergone…
Abstract Performing medial branch blocks with ultrasound guidance is an alternative method to perform diagnostic blocks. Theoretically, using ultrasound guidance negates the need of fluoroscopy, can help avoid unnecessary radiation…
Abstract Sympathetic nerve blocks are used to help with the diagnosis and treatment of sympathetically maintained pain. The lumbar sympathetic chain typically overlies the anterolateral aspect of the first through…
Abstract Often-used synonyms for “neurotomy” include “ablation,” “denervation,” and “lesion.” We do not recommend the term “rhizotomy” because it implies lesioning of nerve roots. Keywords ablation, lesion, low back pain,…
