Taking Aim at Back Pain

Eighty percent of Americans will experience an episode of back pain during their lifetime. Many of these people will go on to have chronic pain issues that negatively impact their ability to work and lead a normal lifestyle. Symptoms can include pain, burning, cramping, numbness, and tingling in the neck, back, buttocks, legs or feet. Causes can include disc herniation, facet joint arthritis, spinal canal stenosis, compression of nerves by bone spurs, osteoporotic compression fractures, piriformis syndrome, Tarlov and synovial cysts of the facet joints, and many other diseases.

The UCSF Precision Spine and Peripheral Nerve Center uses many technologies, such as 64-slice CT scanners and 3 Tesla MRI scanners, to accurately diagnose back pain and tailor a personalized treatment. For instance, we can evaluate the nerves outside of the spine – this helps us identify nerve compression, tumors or damage that conventional spine MR imaging or CT scans would miss. Following diagnosis, pain can be eliminated or reduced by using CT scans to guide the placement of medication precisely to the area of concern. Patients often decrease their reliance on pain medications and delay or even avoid spine surgery altogether.

CT-guided advanced spinal treatment provides a clear advantage over the more commonly used fluoroscopic methods of needle placements. CT enables physicians to see nerves, muscles, blood vessels, and bones, as well as the pathology causing your pain. Fluoroscopy is limited to two-dimensions and only the bones can be seen. Therefore, CT-guidance allows a physician to aim at a target and precisely deliver medication directly around the anatomy in questions, while avoiding injuring critical structures.  Furthermore, some procedures can only be performed using CT-guidance, such as Tarlov and synovial cyst aspirations injections and aspirations. With the use of software, the radiation doses from CT scanners are at the same or lower doses as x-ray fluoroscopy.

With CT-guidance, procedures such as epidural steroid injections, spinal and sacral nerve blocks, radiofrequency ablations, piriformis injections, Tarlov and synovial cyst injections and aspirations, kyphoplasties, vertebroplasties, and other advanced spinal treatments can be performed safely and successfully – especially in patients where fluoroscopic-guidance has failed.

To learn more about the UCSF Precision Spine and Peripheral Nerve Center, click here.