Thoroughly illustrated with state-of-the-art CT and fluoroscopic scans and original drawings, this text/atlas offers step-by-step instructions for image-guided pain block techniques in regional anesthesia and pain medicine. Dr. Rathmell demonstrates how to perform all commonly used injection techniques and familiarizes pain practitioners with the radiographic anatomy encountered during these procedures.

For each procedure, Dr. Rathmell provides details on patient selection, patient positioning, technique, and potential complications, with special attention to the use of radiographs to guide needle or catheter placement. Each technique is illustrated with a drawing and CT or fluoroscopic images, with legends highlighting anatomic landmarks on the images.

 

Table Of Contents Preface ix

Acknowledgments xi

Foreword xiii

SECTION I: BASIC TECHNIQUES, RADIATION SAFETY, AND PHARMACOLOGY
1. Basic Techniques for Image-Guided Injection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3
2. Radiation Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
3. Radiographic Contrast Agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
4. Pharmacology of Agents Used During Image-Guided Injection . . . . . . . . . . . . .23

SECTION II: SPINAL INJECTION TECHNIQUES
5. Interlaminar Epidural Injection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31
6. Transforaminal and Selective Nerve Root Injection . . . . . . . . . . . . . . . . . . . . . . . . . .53
7. Facet Injection: Intra-articular Injection, Medical Branch Block, and
Radiofrequency Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .65
8. Sacroiliac Joint Injection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .93
9. Lumbar Discography and Intradiscal Electrothermal Therapy . . . . . . . . . . . . .101

SECTION III: SYMPATHETIC AND PERIPHERAL NERVE BLOCKS
10. Stellate Ganglion Block . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .115
11. Celiac Plexus Block and Neurolysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .123
12. Lumbar Sympathetic Block and Neurolysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .135
13. Superior Hypogastric Block and Neurolysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .143
14. Intercostal Nerve Block and Neurolysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .151

SECTION IV: IMPLANTABLE DEVICES

15. Implantable Spinal Drug Delivery System Placement . . . . . . . . . . . . . . . . . . . . . .161
16. Spinal Cord Stimulation System Placement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .171