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…
Thoracic Zygapophysial Joint Nerve (Medial Branch) Injection—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 . Key Words back pain, diagnostic,…
Intercostal Blockade: Fluoroscopic Guidance
Abstract Typically, intercostal blockade may be performed with a trajectory view angled superiorly toward the inferior aspect of the intended costal margin, followed by the anteroposterior (AP) and lateral fluoroscopic…
Vertebral Augmentation (Vertebroplasty/Kyphoplasty): Transpedicular Approach
Abstract Vertebral body compression fractures are estimated to occur approximately 700,000 times each year. This presents a significant public health challenge from the standpoints of morbidity, mortality, and health care…
Thoracic Zygapophysial Joint Intraarticular Injection—Posterior Approach: Fluoroscopic Guidance
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…
Intercostal Nerve Injection, In-Plane Approach, Ultrasound Guidance
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,…
Thoracic Transforaminal Epidural Steroid Injection: Infraneural Approach
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…
Thoracic Interlaminar Epidural Steroid Injection: Paramedian Approach
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…
L5-S1 Disc Access
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…
