Putting the medicine where the inflammation is

UCSF Radiologist Dr. Hess describes the importance proper inflammation medicine application when it is used for back pain reduction.
 

Medications: Steroids

  • Reduce inflammation by reducing chemical mediators
  • Potency enhanced by delivery to site of inflammation
  • Steroids do NOT:
    • Change anatomy or reverse degenerative disease
    • Shrink herniated discs
  • Most formulations corticosteroid esters (particulate)
    • Decadron
    • Celestone
    • Kenalog
    • Depo-medrol

Medications: Anesthetics

  • Inhibit nerve excitation or conduction
  • Differ in potency, onset, duration (lipid solubility)
  • Most formulation used for injection are amides
    • Lidocaine
    • Bupivacaine
    • Ropivacaine

Medications: Cement

  • Provides internal stabilization for fractures
  • Liquid monomer cross-links with powdered polymer
  • Glue-like substance that “sets” quickly (4-15 minutes)
  • Viscosity and mechanical properties vary by formulation
    • PMMA 

Faculty

Professor
Chief of Neuroradiology
Associate Chair for Quality and Safety
Co-Director, Neuroimaging RIG
Professor, Clinical Radiology

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