Prepare for CT-Guided Interventional Spine

We cannot perform your procedure if you are at risk of bleeding or are on medications that promote increased bleeding. We prefer that you stop such medications at least 5 days prior to your procedure. In some cases (Coumadin® or warfarin) it will be necessary to obtain a laboratory test (INR) prior to your procedure.

Such medications include:

• Aspirin or aspirin containing compounds ( 5 days )
• Plavix® (5 days)
• Coumadin® (warfarin) (5 days, check INR bloodwork before coming)
• Lovenox® (take the last dose in the morning the day before your exam)
• Non-steroidal anti-inflammatory agents (Motrin®, Ibuprofen, etc.) (5 days)

Please consult with your doctor to make sure that it is medically safe to temporarily discontinue your medications, and consult with our nurses if you have any questions by calling 415-353-3717.

A UCSF Precision Spine Center nurse will contact you by telephone one week before your appointment. During this call, the nurse will review our Patient Safety and Procedure Preparation Tips.

• Tell us if you have a drug or CT scan contrast allergy.
• Tell us if you are taking blood thinners such as Coumadin®, Plavix®, or aspirin
• Tell us if you are pregnant or if you think you might be pregnant.
• Do not bring valuables with you.
• Tell us if you need an interpreter.
• Bring a list of your current medications with dosage information.
• Feel free to ask questions or tell us additional information.
• Make sure you have a person to drive you home following the procedure.
• If you like, plan to bring a snack (e.g. juice, health bar) to eat after your procedure. Otherwise, we will provide a snack.

​Eating and drinking recommendations: please refer to conscious sedation below.

• The day of the procedure take your routine medications with a small sip of water — unless told otherwise by your doctor or our nurses.
• Bring copies of spinal x-rays, CT scans, or MRI scans (films or CD-ROMs) ) if not obtained at UCSF.
• Arrive about 1 (one) hour early the day of your procedure.
• Before the procedure, the doctor will talk with you about what you may experience and he/she will ask you to sign a consent form. Feel free to ask questions.

You are asked to complete certain paperwork to document the current level and location of your pain. Thereafter, you are escorted to a private area where you change into a gown and bathrobe. Your belongings are kept safe and secure in a personal locker.

You and a family member meet with the doctor, who explains the details of your procedure and obtains your signed consent. Please feel free to ask any questions.

A UCSF Precision Spine Center nurse greets you and settles you into a bed and typically places a small IV catheter (intravenous tube) into your arm. The purpose of the IV catheter is to administer sedatives before and during your procedure. Sedatives help you remain relaxed and comfortable.

Next, you are wheeled into the procedure room by our technologist and nurse and connected to monitors to observe your heart rate, blood pressure, and breathing patterns. Our expert nurses and physicians will closely monitor you throughout the entire procedure. If you feel pain or anxiety at any time, simply request additional medication. We want you to be as comfortable as possible.

Many of our patients prefer to undergo their procedures using mild conscious sedation. Our credentialed nursing and physician staff are well-trained to administer conscious sedation, and monitor their patients continuously to ensure their comfort throughout the procedure. If you are having sedation it is important to refrain from eating for at least 6 hours prior to your procedure. For questions, please call our nursing staff at the China Basin Precision Spine Center at (415) 353-3717.

After the procedure, you are observed for one hour in the recovery room. Here your vital signs (e.g. blood pressure, breathing) continue to be monitored while you wake up. The recovery period gives you and your physician the opportunity to evaluate your response to the treatment.

Your family can join you at your bedside. Our nurses provide you with the snack food you brought from home or provide something to eat and drink.

• Drink plenty of fluids, but avoid drinks with caffeine or alcohol for 24 hours.
• Resume your usual medications, including your pain medicine, if needed.
• You may shower the day after your procedure.
• Remove the bandage(s) from the needle puncture site(s) the day after your procedure.
• Inspect the needle puncture site(s) for redness, swelling, bleeding, or pus.

If you develop redness, swelling, bleeding, or pus, or develop a fever please call the UCSF Precision Spine Center Nurse at 415-353-3717.

When you are discharge from the Precision Spine Center you will be given a phone number so you can contact a neuroradiologist after-hours if you feel you need to speak to one of our physicians. Alternatively, if you feel you are having a medical emergency, you should call 911 or go to the nearest emergency room.

• For the next 3 days avoid: bathes, hot tubs, pools, bending, stooping, strenuous exercise, straining for a bowel movement, and lifting heavy objects.
• Twice a day, every day for 14 days after your procedure, record the location and level of your pain from 0 (no pain) to 10 (extreme pain). For example:

  Back pain = 3/10 (3/10 means your pain is a "3" on a 10-point scale)
  Leg pain = 5/10 (5/10 means your pain is a "5" on a 10-point scale)

  This information will help you, the neuroradiologist, and your doctor to evaluate the effectiveness of treatment.

If you received sedation, for the next 24 hours we recommend:

• Have a responsible adult return you to your home.
• Rest, take it easy.
• Resume eating, but begin with light foods (e.g. clear juice, soup, Jell-O) and progress to solid food.
• Drink plenty of fluids, but avoid drinks with caffeine and alcohol.
• Do not drive or operate hazardous machinery.
• Do not make important personal or business decisions.

Normal: You may experience mild pain at the needle puncture site(s).

Call us if you develop:

• Vomiting
• Temperature greater than 101 degrees F
• Pain that is not controlled by your usual pain medication
• Redness, swelling, bleeding, pus or drainage from a needle puncture site
• New or increased numbness or tingling in your arm(s) or leg(s)
• Difficulty urinating