Overview

Written by a multidisciplinary team of experts, Spinal Injection Techniques presents all common methods for the injection of local anesthetics to address pain from the cervical spine to the sacrum. The authors describe techniques that are viable alternatives to spine surgery and that do not rely on diagnostic imaging. The first section of the book covers a general soverview of the basic principles, diagnostics, and causal as well as symptomatic pain therapy for the spine. Designed in atlas format, the second ...
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Spinal Injection Techniques

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Overview

Written by a multidisciplinary team of experts, Spinal Injection Techniques presents all common methods for the injection of local anesthetics to address pain from the cervical spine to the sacrum. The authors describe techniques that are viable alternatives to spine surgery and that do not rely on diagnostic imaging. The first section of the book covers a general soverview of the basic principles, diagnostics, and causal as well as symptomatic pain therapy for the spine. Designed in atlas format, the second section includes chapters on spinal anatomy and pain signaling, techniques for injection therapy of the cervical, thoracic and lumbar spine, management of potential complications and side effects, and multimodal spine therapy. Illustrated by real-life photographs from the author’s practice, each technique-related chapter guides the reader step-by-step and with great precision through the injection procedures. Highlights:• Provides detailed coverage of injection therapy without the use of image guidance• Features inpatient and outpatient minimally invasive spine therapy, and concomitant pharmaceutical treatments• Includes essential information on contraindications and patient consent• More than 400 color illustrations and photographs demonstrate the relevant anatomy, patient positioning, and accurate needle placementDesigned as a practical guide and useful compendium, Spinal Injection Techniques is invaluable for orthopedists and practitioners in physical medicine and rehabilitation. It is also a handy reference for anesthesiologists, neurologists, and rheumatologists with a specific interest in pain therapy for the spine.Theodoros Theodoridis, MD, is Orthopedist in private practice, Bochum, Germany.Juergen Kraemer, MD, is Professor Emeritus, Department of Orthopedics, University Clinic, St. Josef Hospital, Bochum, Germany.An award-winning international medical and scientific publisher, Thieme has demonstrated its commitment to the highest standard of quality in the state-of-the-art content and presentation of all of its products. Thieme’s trademark blue and silver covers have become synonymous with excellence in publishing.
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Editorial Reviews

From the Publisher

Production values for the book are very high, with excellent reproduction of illustrations and photographs...well written...the use of step-by-step illustrationsr combined with demonstrations of the anatomy in cadaveric specimens isexcellent...particularly useful.--Anaesthesia and Intensive CareIn this visual reference, a multidisciplinary team of experts describes techniques that are viable alternatives to spine surgery...[includes] about 400 color clinical, cadaver, and skeletal photos, b&w diagnostic images, and color anatomical and process illustrations to demonstrate the relevant anatomy, patient positioning, and accurate needle placement...Each technique-related chapter guides the reader step-by-step through the injection procedures.--www.booknews.comIn this visual reference, a multidisciplinary team of experts describes techniques that are viable alternatives to spine surgery and that do not rely on diagnostic imaging. Common methods for the injection of local anesthetics to address back pain are illustrated with about 400 color clinical, cadaver, and skeletal photos, b&w diagnostic images, and color anatomical and process illustrations to demonstrate the relevant anatomy, patient positioning, and accurate needle placement...Each technique-related chapter guides the reader step-by-step through the injection procedures.--SciTech Book News
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Product Details

  • ISBN-13: 9783131475817
  • Publisher: Thieme
  • Publication date: 1/1/2011
  • Sold by: Barnes & Noble
  • Format: eBook
  • Edition number: 1
  • Pages: 253
  • File size: 44 MB
  • Note: This product may take a few minutes to download.

Meet the Author

Director, Department for Spine Therapy and Orthopedic Surgery, Viktoria Clinic Bochum, Germany

Professor, formerly Orthopedic University Clinic, St. Josef's Hospital, Bochum, Germany

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Table of Contents

I General Section

1 Basic Principles 3

Orthopedic Pain Therapy 3

Nociception and Chronification 4

Stages in the Development of Pain 5

Moving from Acute to Chronic Pain: Nociceptor Sensitization 6

Secondary Pain 8

Mixed Pain Syndrome 9

Chronic Pain Syndrome 10

2 Diagnostics 13

Medical History 13

Clinical Examination 14

Neurological-Orthopedic Examination 16

Laboratory Tests 17

Imaging Techniques 18

Trial Measures for the Diagnosis of Pain 18

3 Causal Orthopedic Pain Therapy 19

Positioning and Traction 19

Orthopedic Aids 20

Manual Therapy 20

Physical Therapy 21

Postural and Behavioral Training; Back School 22

Back School and Orthopedic Pain Therapy 22

4 Symptomatic Pain Therapy 25

Introduction 25

Thermotherapy 26

Massage 27

Electrotherapy 28

Acupuncture 29

Therapeutic Local Injection Treatment 30

Interleukin-1 Receptor Antagonist Protein (IL-Ra) 33

Multimodal Medication Concomitant Therapy 36

Introduction 36

Pain Measurement and Documentation 36

WHO Analgesic Ladder 37

Opioid Management 46

Adjuvant Analgesics 46

Local Anesthesia 49

5 The Spine: Anatomy, Nociception, and the Distribution of Pain Signals 53

Terminology 53

Nociception and the Distribution of Pain Signals in the Spine 53

Pain-Sensitive Structures in the Vertebral Motor Segment 53

Motor Segment 53

Spinal Nerve 54

Posterior Longitudinal Ligament 55

Nerve Root 55

Nociceptive Pain Arising from the Zygapophyseal Joints 57

Muscles 57

Mixed Pain Syndromes in the Spine 59

Chronic Pain Arising from the Vertebrae 59

6 Special Orthopedic Injection Therapy: Contraindications and Patient Information 61

Contraindications61

Patient Information 62

7 Cervical Injection Therapy 65

Specialized Cervical Neuroanatomy 65

Basic Therapy for Cervical Pain 66

Special Therapy for Cervical Pain 68

Local Cervical Pain Syndrome 68

Pain Therapy for the Cervicobrachial Syndrome 70

Treatment of Cervical Headaches (Cervicocephalic Syndrome) 71

Pain Therapy for the Posttraumatic Cervical Syndrome 71

Cervical Injection Therapy 72

Cervical Spinal Nerve Analgesia 72

Cervical Epidural Injection 81

Cervical Facet Infiltration (CxFI) 89

Cervical Trigger Point Inflitration and Skin Inflitration 95

8 Thoracic Injection Therapy 99

Specialized Thoracic Neuroanatomy 99

Clinical Picture 100

Thoracic Injection Therapy 101

Thoracic Spinal Nerve Analgesia 101

Thoracic Facet Infiltration (TxFI) 107

Costotransverse Block (CTB) 110

9 Lumbar Injection Therapy 113

Specialized Lumbar Neuroanatomy 113

Basic Therapy for Lumbar Pain 115

Special Therapy for Lumbar Pain 118

Local Pain Syndromes in the Lumbar Spine (Local Lumbar Syndrome, Nonspecific Back Pain) 118

Treatment of Acute Low Back Pain 119

Treatment of Chronic Low Back Pain 119

Pain Therapy for the Lumbar Nerve Root Syndrome 120

Pain Therapy for Lumbar Spinal Canal Stenosis 121

Decompensated Spinal Canal Stenosis 121

Pain Therapy for Problem Patients Who Have Undergone Spinal Surgery 122

Pain Following Lumbar Spondylodesis 124

Lumbar Injection Therapy 125

Lumbar Spinal Nerve Analgesia 125

Radiculography 139

Lumbar Facet Infiltration 139

Ligament Infiltration at the Sacroiliac Joint (SIJ Block) 149

Lumbar Spidural Pain Therapy 157

10 General and Specific Complications and Treatment Measures 197

Vasovagal Syncope 197

Intravascular Administration of Local Anesthetics and Glucocorticoids 197

Central Nervous System 197

Cardiac Circulatory System 198

Intrathecal Administration of Local Anesthetics and Glucocorticoids 199

Anaphylactoid Reaction-Anaphylactic Shock 199

Postdural Puncture Syndrome 201

Bacterial Infection 201

Bleeding 203

Special Complications and Side Effects of Cervical Spinal Nerve Analgesia (CSPA) 204

Stellate Block 204

Pneumothorax 204

Nerve Root Sleeve Injection 204

Side Effects and Complications of Cervical Epidural Injections 206

Epidural Injections 206

Dural Puncture 206

Side Effects and Complications of Thoracic Injection Techniques 206

Side Effects and Complications of Lumbar Spinal Nerve Analgesia 206

Spinal Anesthesia 206

Kidney Puncture 207

Side Effects and Complications of Lumbar Epidural Injections 207

Dural Puncture 207

11 Multimodal Spinal Therapy 209

Outpatient Minimally Invasive Spinal Therapy 209

In-patient Minimally Invasive Spinal Therapy 211

Medical Interventions 212

Physical therapy 212

Psychotherapy 212

Special Interventions 212

Indications for In-patient Minimally Invasive Spinal Therapy 213

Diagnostics Required before Commencing Minimally Invasive Spinal Therapy 213

Multimodal Program 214

Initial Medical Intervention 214

Second Medical Intervention 214

Positioning 215

Pain Medication 215

Physical therapy 215

Psychotherapy 215

The 5-10 Day In-Patient Minimally Invasive Spinal Therapy Program 215

Osteoporotic Fractures 216

Further Outpatient Treatment 217

Indications for Surgery 218

Results 218

12 Summary 221

Cervical Spine 221

CSPA (Cervical Spinal Nerve Analgesia) 221

CEI (Cervical Steroid Injection) 222

CxFI (Cervical Facet Inflitration) 222

Thoracic Spine 223

TSPA (Thoracic Spinal Nerve Analgesia) 223

TxFI (Thoracic Facet Infiltration) 224

CTB (Costotransverse Block) 225

Lumbar Spine/Sacrum 226

LSPA (Lumbar Spinal Nerve Analgesia) 226

LxFI (Lumbar Facet Infiltration) 227

SIJ Block (Infiltration of Ligaments at the Sacroiliac Joint) 227

Epi-Sacral (Sacral Epidural Injection) 228

Epi-posterior (Posterior Epidural Injection) 229

Epi-peri (Epidural Perineural Injection) 230

Conclusion 231

Bibliography 233

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