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5 × 8 SPINE: 0.3839 FLAPS: 0 INTERVENTIONAL S PAIN PROCEDURES ab An Imprint of Springer Publishing i Handbook and Video Guide a INTERVENTIONAL | M Michael Sabia, MD a Rajat Mathur, MD t h PAIN PROCEDURES u This multimedia handbook and video atlas provides an interactive learning experience r for practitioners who perform interventional procedures with radiographic guidance for acute or chronic pain. The print text is a formatted portable reference for reviewing I Handbook and Video Guide anatomy, indications, physical examination findings, set-up, technique, and risks and N complications for a wide range of head, neck, spine, and pelvic interventions. T Buyers also have access to the ebook for use on any mobile device or computer, and E twenty-four high quality procedural videos with voice-over narration that walk you R through the interventions. Covering in-demand procedures such as epidural blocks, medial branch blocks, sympathetic blocks, spinal cord stimulation, and more, these V dynamic videos put you in the operating suite as each procedure unfolds. Shot from E the perspective of the interventionalist with a split screen view, the videos correlate N positioning of the needle on the fluoroscopic image to the movement of the practitioner’s hands to help you put it all together. These videos offer the opportunity to “stand in” on T actual procedures with an expert, and demonstrate proper injection technique, effective I O targeting, and live contrast review to build skills in interventional pain management. N All of the essential high yield text, video, and image content are here in an accessible interface for residents, fellows, and seasoned practitioners looking to master A interventional techniques or brush up on current pain management procedures. L KEY FEATURES: P • An integrated handbook, ebook, and video package—accessible anytime, A anywhere I N • Fosters dynamic teaching of interventional pain procedures • A consistent approach to nonsurgical pain relief, covering interventions for spine, P head, neck, and pelvis R • Demonstrates proper technique, needle placement, and precision O targeting for positive outcomes C • Highly illustrated quick-reference print and digital handbook link seamlessly to 24 step-by-step videos with audio E D Michael Sabia Recommended Shelving Category: U Physical Medicine and Rehabilitation; Rajat Mathur Anesthesia R E S An Imprint of Springer Publishing 11 W. 42nd Street New York, NY 10036 www.springerpub.com Interventional Pain Procedures Interventional Pain Procedures Handbook and Video Guide Michael Sabia, MD Division Head Pain Management Pain Medicine Fellowship Director Assistant Professor of Anesthesiology Cooper Medical School of Rowan University Department of Anesthesiology Division of Pain Management Voorhees, New Jersey Rajat Mathur, MD Pain Management Specialist Department of Rehabilitation Medicine Division of Pain Management MedStar Georgetown University School of Medicine Washington, DC Visit our website at www.springerpub.com ISBN: 9781620701027 ebook ISBN: 9781617052798 Acquisitions Editor: Beth Barry Compositor: diacriTech Copyright © 2019 Springer Publishing Company. Demos Medical Publishing is an imprint of Springer Publishing Company, LLC. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher. Medicine is an ever-changing science. Research and clinical experience are continually expanding our knowledge, in particular our understanding of proper treatment and drug therapy. The authors, editors, and publisher have made every effort to ensure that all information in this book is in accordance with the state of knowledge at the time of production of the book. Nevertheless, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the contents of the publication. Every reader should examine carefully the package inserts accompanying each drug and should carefully check whether the dosage schedules mentioned therein or the contraindications stated by the manufacturer differ from the statements made in this book. Such examination is particularly important with drugs that are either rarely used or have been newly released on the market. Library of Congress Cataloging-in-Publication Data Names: Sabia, Michael, author. | Mathur, Rajat, author. Title: Interventional pain procedures : handbook and video guide / Michael Sabia, Rajat Mathur. Description: New York : Springer Publishing Company, [2018] Identifiers: LCCN 2018000374| ISBN 9781620701027 | ISBN 9781617052798 (e-book) Subjects: | MESH: Pain Management—methods | Spine—surgery | Spinal Cord Stimulation | Autonomic Nerve Block—methods | Radiography, Interventional | Handbooks Classification: LCC RD768 | NLM WL 39 | DDC 617.4/71—dc23 LC record available at https://lccn.loc.gov/2018000374 Contact us to receive discount rates on bulk purchases. We can also customize our books to meet your needs. For more information please contact: [email protected] Printed in the United States of America. 18 19 20 21 22 / 5 4 3 2 1 To my mom and dad, your love and guidance ignited a fire inside of me which allows me to give my all everyday. Your presence alone fuels my hunger to improve the quality of care I render to patients on a daily basis. I’m forever grateful for the life you’ve provided for me. Thank you for believing in me and supporting me throughout this lifetime journey. To my children, Sebastian and Milana, I promise to love and care for you until the end of time. Hard work, determination, and being regimented are the key ingredients to success. To the staff at Cooper University Hospital and the Voorhees Surgery Center. I am eternally thankful for the excellent training I’ve received. Being around a group of such talented and dynamic healthcare providers helped nurture my passion for healing pain and suffering. Michael Sabia To my wife, thank you for your understanding and unconditional love. You make me and everyone you come across a better human being, I TRULY cannot imagine life without you. To my mom and dad, I am who I am because of you both. Thank you for your trust, values, and most importantly love. My dreams would be impossible without you both! To my sister, thank you for your trust and belief in me, especially during those times when I did not believe in myself! To my son, your presence in my life brings me the kind of happiness that I did not know was possible. I am excited to be a part of your life and know you will make the world a better place. To Dr. Michael Sabia, thank you for being my role model of what a physician should be and a wonderful mentor to me. Rajat Mathur Contents List of Videos xi Preface xv Share Interventional Pain Procedures: Handbook and Video Guide 1. ANATOMY OF SPINE AND SPINAL CORD FOR PAIN PROCEDURES 1 Spine 1 Spinal Cord 8 Epidural Space 8 Spinal Nerves 10 2. C-ARM OVERVIEW 13 Radiation Safety 13 Biologic Effects of X-rays 14 Radiographic Contrast Agents 17 Needle Anatomy and Techniques 18 3. PHARMACOTHERAPY IN PAIN MANAGEMENT 21 Nonsteroidal Anti-Inflammatories 21 Opioids 22 Antispasmodics 26 Tricyclic Antidepressants 27 Selective Serotonin Reuptake Inhibitors 28 Serotonin–Norepinephrine Reuptake Inhibitor 28 Other Antidepressants Commonly Used 29 Anticonvulsants 29 Interventional Pharmacology 30 Local Anesthetics 30 Corticosteroids 31 Contraindications for Corticosteroids in Interventional Pain Management 32 ASRA Preprocedural Management of Anticoagulants and Antiplatelets 32 Schedule Medications 35 viii Contents 4. CERVICAL SPINE 37 Disorders of the Cervical Spine 37 Cervical Spondylosis 37 Cervical Radiculopathy 39 Cervical Spondylotic Myelopathy 44 Cervical Spinal Stenosis 48 Cervical Facet Mediated Pain 50 Commonly Performed Procedures in the Cervical Spine 52 Cervical Interlaminar Epidural Injection 52 Cervical Medial Branch Blocks 59 Radiofrequency Ablation of the Cervical Medial Branches 63 5. THORACIC SPINE 71 Thoracic Radiculopathy/Myelopathy 71 Thoracic Compression Fracture 75 Chest Wall Pain Syndrome 77 Thoracic Interlaminar Epidural Steroid Injection 79 Intercostal Nerve Block 85 6. LUMBAR SPINE 93 Lumbar Spondylosis Without Myelopathy 93 Lumbosacral Radiculopathy 96 Lumbar Spinal Stenosis 105 Lumbar Spondylolisthesis 110 Postlaminectomy Pain 114 Sacroiliac Joint Dysfunction 117 Lumbar Interlaminar Epidural Steroid Injection 120 Lumbar Transforaminal Epidural Steroid Injections 126 Caudal Epidural Steroid Injection 132 Lumbar Medial Branch Block 137 Sacroiliac Joint Injection 143 7. SYMPATHETIC BLOCKS 151 Stellate Ganglion Block 151 Celiac Plexus Block 156 Lumbar Sympathetic Block 161 Superior Hypogastric Block 166 Ganglion Impar Block 171 Complex Regional Pain Syndrome 175 Contents ix 8. SPINAL CORD STIMULATION 179 Mechanism of Action 179 Indications 179 Screening 180 Equipment 181 Procedure Planning 182 Trial Technique 183 Complications 184 Current Companies Offering Spinal Cord Stimulation 184 9. BONUS VIDEOS: OTHER COMMONLY PERFORMED PROCEDURES 191 Trigeminal Nerve Block 191 Subacromial Bursa Injection 192 Trochanteric Bursa Injection 194 Piriformis Injection 195 Genicular Nerve Block 197 10. COMMON PAIN DIAGNOSIS AND ICD CODES 201 Index 221