Dados do Trabalho

Título

No more pain: a guide for lumbar spine transforaminal and interlaminar procedures

Introdução e objetivo(s)

This pictorial essay aims to review intervention musculoskeletal procedures for low back pain relief in acute and outpatient settings, including patient selection, imaging planning and findings. Other objectives are to show: a guide for patient interviews; the crucial aspects of pre-procedural planning; a walkthrough for performing both interlaminar and transforaminal lumbar spine infiltrations, as well as vertebroplasty. Technical challenges and complications; practical tips, patient outcome and follow-up post procedure will also be discussed.

Método(s)

Pictorial essay and medical literature review

Discussão

CT-guided lumbar spine procedures are essential in managing chronic low back pain (LBP), particularly in cases of radiculopathy, facet joint arthropathy, and degenerative disc disease. The use of computed tomography (CT) for guidance ensures accurate needle placement, reduces complications, and enhances therapeutic outcomes, given the right patient selection and technical planning.
Among the most performed CT-guided interventions is epidural steroid injection (ESI), which involves delivering corticosteroids and anesthetics into the epidural space. Compared to fluoroscopic techniques, CT guidance provides superior anatomical visualization, particularly beneficial for patients with altered spinal anatomy due to previous surgery or congenital variations. The precise localization of the needle tip and direct visualization of contrast spread optimize drug deposition while minimizing risks such as intravascular or intrathecal injection.
Selective nerve root blocks (SNRBs) serve both diagnostic and therapeutic roles, allowing targeted administration of corticosteroids and anesthetics to specific nerve roots. These procedures not only provide pain relief but also help confirm the pain generator before considering surgical intervention. The real-time assessment of drug distribution within the perineural space enhances specificity and procedural success.
Other procedures such as facet joint injections and percutaneous vertebroplasty are also used effectively for pain relief under CT guidance.

Conclusões

CT-guided lumbar spine interventions provide high precision and efficacy in managing LBP. With advancements in imaging technology and refinement of injection techniques, their role continues to expand. Integrating these procedures into a multidisciplinary pain management strategy ensures comprehensive care for patients with chronic LBP.

Palavras Chave

Lumbar pain; Musculoskeletal Imaging; Musculoskeletal Intervention

Arquivos