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