Back and Neck Pain

What to Expect After the Injection?

UCSF Radiologist Dr. Dillon goes over what to expect after the spinal injection procedure. REMOVE: "Pain relieve between 2 weeks to 2 months, possible initial pain, results might not be 100%."
 

Nerve Block Produced

Common Spine Injection Procedures

UCSF Radiologist Dr. Dillon explains in detail the different spinal procedures that are performed at UCSF's Precision Spine Center
 
  • Nerve root block (radiculitis)
  • Transforaminal epidural
  • Inter laminar epidural
  • Facet and or medial branch block (facets)
  • RFA for facet arthropathy 

A Peek Inside UCSF Precision Spine Center (PSC)

UCSF Radiologist Dr. Dillon explains how spine precision procedures are conducted at the UCSF Precision Spine Center China Basin Center.
 
Suite that has a monitor from the operator’s console which allows us to position our needle very precisely through little bony channels that it is adjacent to, but not through a nerve.
 
 

How Guided Spine Injections Are Done at UCSF

UCSF Radiology uses CT to guide spine injections and procedures, unlike other centers who uses fluoroscopy. UCSF doctors are able to get more detailed imagining and thus better precision.
 

Fluoroscopy: X-ray machine that shows only 2-D view of bone and some soft tissue, but not nerves

  • Widely available community standard
  • Rely on bony landmarks
  • Soft tissue detail lacking

CT guidance

Guided pain relief

UCSF Radiologist Dr. Hess describes how accurate imaging guidance for spine interventions improves diagnosis and aids in back pain reduction.
 

These procedures are non-surgical procedures in the sense that we don’t use a big knife and we’re not wheeling the patient in the operating room or not knocking you out. All these “surgeries” done through a needle and will inject variety of different medications.

Accurate image guidance for spine interventions improves diagnosis and helps to reduce back pain.

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

What causes sciatica?

UCSF Radiologist Dr. Hess describes what causes spinal disorders such as sciatica.
 
Radicular Pain
  • Many Causes
    • Discs
    • Bony spurts (osteophytes)
    • Scar (after surgery)
    • Sometimes other things
  • One or more nerve roots 
  • Locations
    • Within the spinal canal
    • Within the neural foramen
    • Extra-spinal

Treating back pain at the root

UCSF Radiologist Dr. Hess describes how medical imaging can assist in back pain management at the source.
 

Place the needle in three places

  1. Selective nerve root block
  2. Transforaminal epidural
  3. Interlaminar epidural

Technique

Targeting pain precisely

UCSF Radiologist Dr. Hess describes the advantages of using CT medical imaging in imaging guidance and medical imaging.
 

ESI: Outcomes

Long term relief: Abdi S et al. Pain Physician 2007 and Buenaventura R. et al, Pain Physician 2009

Using Imaging to uncover the real problem

UCSF Radiologist DR. Hess explains why a CT scan imaging guidance helps uncover real source of pain.
 

Another reason for doing CT it that we have a better idea of what we’re seeing and to come up with alternative diagnoses in real time.  

 

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