KEY FACTS Terminology Selective image-guided injection of long-acting anesthetic and corticosteroid into piriformis muscle adjacent to sciatic nerve in treatment of piriformis syndrome Some advocate intramuscular botulinum toxin A injection Preprocedure Injection is generally reserved for cases in which conservative…
KEY FACTS Terminology Selective corticosteroid and long-acting anesthetic injection of sacral nerve root at level of neural foramen Preprocedure Malignant or benign neoplasm Imaging Evaluate relevant anatomic landmarks Search for other causes of patient pain Procedure Anchor 22-gauge spinal needle…
KEY FACTS Terminology Image-guided injection of corticosteroid and long-acting anesthetic into sacroiliac (SI) joint Preprocedure Indications Diagnostic injection for hip/back/buttock pain Sacroiliitis Synovial cyst associated with SI joint Procedure Prone Oblique tube angulation to “open” SI joint Advance needle under…
TERMINOLOGY Definitions Sacrum is large triangular bone formed from 5 fused vertebrae at base of vertebral column GROSS ANATOMY You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are…
KEY FACTS Terminology Fine-needle aspiration of intervertebral disc material ± core biopsy Preprocedure Coagulopathy/anticoagulation studies Prothrombin time, activated partial thromboplastin time, international normalized ratio Hemoglobin, hematocrit, and platelet count Suspected osteomyelitis/discitis To confirm infectious organism Procedure For thoracic and lumbar…
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KEY FACTS Terminology Percutaneous disc removal to reduce intradiscal pressure → protruded disc retracts back in place, reduced irritation on annulus nociceptive nerve receptors Also decompresses nerve root from disc Another proposed mechanism: Removing disc material may prevent release of…
KEY FACTS Terminology Image-guided percutaneous vertebral biopsy Cerebrospinal fluid Preprocedure Indications Suspected tumor (biopsy ± vertebroplasty/kyphoplasty) Osteomyelitis/discitis (identify responsible organism, determine antimicrobial sensitivity) Procedure Biopsy ± fine-needle aspiration (FNA) ± vertebroplasty, kyphoplasty, vertebral augmentation Selection of biopsy system to use…
KEY FACTS Terminology Percutaneous stabilization of sacral fracture via bone cement injection Preprocedure Indications Insufficiency fracture Pathologic fracture Posttraumatic fracture Laboratory data Coagulation parameters Infection/inflammation markers Imaging Consistent with acute/subacute fracture Look for retropulsion of bone fragments into sacral canal…