Spinal Injections

spineclass.com

Spinal Injections

Diagnostic and

Therapeutic Spinal

Injections

George Ampat

Consultant Orthopaedic Surgeon


This is not a spinal

injection.

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• Caudal Epidural

• Transforaminal Nerve Root

Blocks

• Facet Joint / MB Blocks

• Discogram

• Biopsy

• Intra Discal Electro Therapy

• Direct injection into Sacro Iliac

joint

• Vertebroplasty

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Caudal Epidural

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Targetting

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Shooting through the barrel

Shooting with triangulation

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Targetting

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Targetting

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Targetting

1. Positioning

2. Concordant Pain

3. Contrast Study

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Targetting

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Discography

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Discography

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Discography

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N Root Block

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N Root Block

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Fluoroscopically guided transforaminal

injections serve as an important tool in the

nonsurgical management of lumbosacral

radiculopathy secondary to a herniated

nucleus pulposus.

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Improvement during the follow-up period

was found in both the methylprednisolone

and saline groups. The combination of

methylprednisolone and bu-pivacaine seems

to have a short-term effect, but at 3 and 6

months, the steroid group seems to

experience a “re-bound” Phenomenon.

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Facet Blocks

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Radiofrequency lumbar zygapophysial

joint denervation results in a significant

alleviation of pain and functional disability in

a select group of patients with chronic low

back pain, both on a short-term and a longterm

basis.

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Although radiofrequency facet joint denervation

may provide some short-term

improvement in functional disability among

patients with chronic low back pain, the

efficacy of this treatment has not been

established.

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Intra Discal Electro Thermy (IDET)

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Intra Discal Electro Thermy (IDET)

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Intra Discal Electro Thermy (IDET)

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Intra Discal Electro Thermy (IDET)

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Intra Discal Electro Thermy (IDET)

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A statistically significant improvement in

functional outcome was obtained in patients

with chronic discogenic low back pain treated

thermally by the SpineCath.

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SI Joint Injections

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Improvement of back pain 2.9 and leg pain 3.3.

ODI improvement of 15

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Biopsy

♦68 Year old male with pain lower

back following an injury in the

garden 1/12 ago.

♦No neurological deficit.

♦Pain at night prompted urgent MRI

scan.

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Biopsy

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Biopsy

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Biopsy

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Biopsy

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Biopsy

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Biopsy

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Vertebroplasty

NORMAL

OSTEOPOROSIS

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Vertebroplasty

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Vertebroplasty

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Vertebroplasty

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Vertebroplasty

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Sobajima S, Kim JS, Gilbertson

LG, Kang JD

Gene therapy for degenerative

disc disease.

The successful in vivo transfer of

therapeutic genes to target cells

within the intervertebral disc in

clinically relevant animal models of

Degenerative Disc Disease.

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Nishida K, Kang JD, Suh JK, Robbins

PD, Evans CH, Gilbertson LG.

Spine. 1998 Nov 15;23(22):2437-42

Adenovirus-mediated gene transfer to

nucleus pulposus cells. Implications for the

treatment of intervertebral disc degeneration.

CONCLUSIONS: The results show the

feasibility of adenovirus-mediated gene

transfer to the intervertebral disc.

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Chemical

Fertiliser.

Non Organic

Farming

Earthworms

Organic Farming

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Inorganic chemicals.

Non Organic MISS

(Minimally Invasive

Spinal Surgery)

Adenovirus

Organic MISS

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I

Thompson’s

Classification

of Disc

Degeneration

II

III

IV

V

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Thank You

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