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Acta Chirurgica Latviensis

The Journal of Riga Stradins University; Latvian Association of Surgeons; Latvian Association of Paediatric Surgeons

2 Issues per year

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Online
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2199-5737
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Interventional Pain Management using Fluoroscopy and Ultrasound Imaging Techniques

Irina Evansa
  • Hospital of Orthopaedic Surgery, Riga, Latvia
  • Department of Anaesthesiology and Reanimatology, Riga Stradins University, Latvia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Edgars Vasilevskis / Michail Aron / Inara Logina / Indulis Vanags
Published Online: 2011-04-07 | DOI: https://doi.org/10.2478/v10163-011-0020-2

Interventional Pain Management using Fluoroscopy and Ultrasound Imaging Techniques

Interventional injection therapies play a major role in the management of various pain conditions and are becoming an integral part of the multidisciplinary therapies required to improve and rehabilitate pain patients. Many of these procedures have historically been performed without imaging guidance. Imaging-guided techniques with fluoroscopy or ultrasound increase the precision of these procedures and help confirm needle placement. Imaging-guided techniques should lead to better results and reduced complication rates and they are now becoming more popular. These improvements are probably due in part also to better patient selection by experienced pain physicians.

Keywords: pain management; spinal interventions; imaging techniques; fluoroscopy; ultrasound; visualization

  • Arzola C, Davies S, Rofaeel A, Carvalho JC. Ultrasound using the transverse approach to the lumbar spine provides reliable landmarks for labor epidurals // Anesth Analg, 2007; 104:1188-1192CrossrefWeb of SciencePubMedGoogle Scholar

  • Benzon H T., Raja SN, Molloy RE. Essentials of pain medicine and regional anesthesia // 2nd ed. Elsevier Inc, 2005; 516-520Google Scholar

  • Botwin KP, Gruber RD, Bouchlas CG et al. Complications of fluoroscopically guided caudal epidural injections // Am J Phys Med Rehabil, 2001; 80:416-424PubMedCrossrefGoogle Scholar

  • Chou R, Baisden J, Carragee EJ, Resnick DK, Shaffer WO, Loeser JD. Surgery for low back pain: a review of the evidence for an American Pain Society Clinical Practice Guideline // Spine, 2009; 34(10): 1094-1096Google Scholar

  • Fredman B, Ben Nun M, Zohar E. Epidural steroids for treating "failed back surgery syndrome": Is fluoroscopy really necessary? // Anesthesia Analgesia, 1999; 88: 367-372PubMedGoogle Scholar

  • Gofeld M. Ultrasonography in Pain Medicine: A Critical Review // Pain Practice, 2008; 226-240Google Scholar

  • Hogan QH. Epidural anatomy examined by cryomicrotome section. Influence of age, vertebral level, and disease // Regional Anesthesia, 1996; 21: 395-406PubMedGoogle Scholar

  • Huston CW, Slipman CW, Garvin C. Complications and side effects of cervical and lumbosacral selective nerve root injections // Arch Phys Med Rehabil, 2005; 86:277-283PubMedCrossrefGoogle Scholar

  • Houten JK, Errico TJ. Paraplegia after lumbosacral nerve root block: report of three cases // Spine, 2002; 2:70-75Google Scholar

  • Hopwood MB, Manning DC. Lumbar epidural steroid injections: Is a clinical trial necessary or appropriate? // Regional Anesthesia Pain Medicine, 1999; 24:5-7CrossrefGoogle Scholar

  • Kalichman L, Cole R, Kim DH, Li L, Suri P, Guermazi A. Spinal stenosis prevalence and association with symptoms: the Framingham Study // Spine Journal, 2009; 9(7): 545-550.CrossrefWeb of ScienceGoogle Scholar

  • Kim PS. Role of injection therapy: review of indications for trigger point injections, regional blocks, facet joint injections, and intra-articular injections // Curr Opin Rheumatol, 2002; 14:52-57CrossrefPubMedGoogle Scholar

  • Klocke R, Jenkinson T, Glew D. Sonographically guided caudal epidural steroid injections // J Ultrasound Med, 2003; 22:1229-1232PubMedGoogle Scholar

  • Lofsky AS. Complications of cervical epidural blocks attract insurance company attention // APSF Newsletter, 2005; 20:45-48Google Scholar

  • Machikanti L, Bakhit CE, Fellows B. Fluoroscopy is medically necessary for the performance of epidural steroid injections// Anesthesia Analgesia, 1999; 89:1330-1331Google Scholar

  • Mehta M, Salmon N. Extradural block: Confirmation of injection site by X-ray monitoring// Anesthesia, 1985; 40:1009-1012CrossrefGoogle Scholar

  • Ma DJ, Gilula LA, Riew KD. Complications of fluoroscopically guided extraforaminal cervical nerve blocks: an analysis of 1036 injections //J Bone Joint Surg Am, 2005; 87: 57-60Google Scholar

  • Peng PWH, Narouze S. Ultrasound-guided interventional procedures in pain medicine: a review of anatomy, sonoanatomy and procedures. Part I: non-axial structures //Reg Anesth Pain Med, 2009; 34:458Y474.1025-30Web of ScienceCrossrefGoogle Scholar

  • Renfrew DL, Moore TE, Kathol MH. Correct placement of epidural steroid injections: Fluoroscopic guidance and contrast administration // Am J Neuroradiology, 1991; 12:1003-1007Google Scholar

  • Rocco AG, Philip JH, Boas RA, Scott D. Epidural space as a Starling resistor and elevation of inflow resistance in a diseased epidural space // Regional Anesthesia, 1997; 22: 167-177CrossrefGoogle Scholar

  • Stalcup ST, Crall TS, Gilula L, Riew KD. Influence of needle tip position on the incidence of immediate complications in 2,217 selective lumbar nerve root blocks // Spine J, 2006; 6:170-176Google Scholar

  • Tripathi M, Nath SS, Gupta RK. Paraplegia after intracord injection during attempted epidural steroid injection in an awake patient // Anesth Analg, 2005; 101:1209-1211CrossrefGoogle Scholar

  • White AH, Derby R, Wynne G. Epidural injection for the diagnosis and treatment of low back pain // Spine, 1980; 5:58-86Google Scholar

  • Yoon JS, Sim KH, Kim SJ, Kim WS, Koh SB, Kim BJ. The feasibility of color Doppler ultrasonography for caudal epidural steroid injection // Pain, 2005; 118:210-214PubMedCrossrefGoogle Scholar

About the article


Published Online: 2011-04-07

Published in Print: 2010-01-01


Citation Information: Acta Chirurgica Latviensis, Volume 10, Issue 2, Pages 102–106, ISSN (Print) 1407-981X, DOI: https://doi.org/10.2478/v10163-011-0020-2.

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