Interventional Radiology of the Spine Image-Guided Pain Therapy

245 Pages·2003·9.24 MB·English

by  Michael Forsting

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Edited by
Edited by
J. Kevin McGraw,
J. Kevin McGraw,
MD
MD
Interventional Radiology of the Spine
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I
NTERVENTIONAL
R S
ADIOLOGY OF THE PINE
I -G P T
MAGE UIDED AIN HERAPY
Edited by
J. K M G ,
EVIN C RAW MD
Riverside Methodist Hospital,
Columbus, OH
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Production Editor: Tracy Catanese.
Cover Illustrations: Figure 5B from Chapter 13, “Treatment of Discogenic Back Pain,” by Jeff S. Silber, J. Kevin McGraw, and John A. Lippert; Figure
7 from Chapter 3, “Magnetic Resonance Imaging of the Spine,” by Eiran Mandelker, Gretchen G. Cordero, Dennis H. Son, and J. Kevin McGraw; Figure
10A from Chapter 8, “Selective Nerve Root Blocks,” by Dennis J. Griffin; and Figure 10 from Chapter 14, “Spinal Biopsy Techniques,” by Thomas
M. Davis.
Cover design by Patricia F. Cleary.
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Library of Congress Cataloging-in-Publication Data
Interventional radiology of the spine: image-guided pain therapy / edited by J. Kevin McGraw.
p. cm.
Includes bibliographical references and index.
ISBN 1-58829-198-7 (alk. paper)
1. Interventional radiology. 2. Spine--Diseases--Treatment. 3. Backache--Treatment. 4. Spine--Imaging.
RD33.55.I585 2003
616.7'306--dc21
2003041650
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Dedication
To my parents,
James and Christine McGraw,
my wife Lisa,
and our sons Reed and Ryan.
v
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Preface
The last century witnessed many changes in the Part II: Interventional Spinal Procedures. Topics
practice of medicine. As we move into the 21st cen- in Part I include basic spinal anatomy, CT, MRI,
tury, we will see more and more procedures performed and nuclear medicine of the spine, and the clinical
with minimally invasive, image-guided techniques. At evaluation of the spine patient. Topics in Part II
the forefront of this revolution is the specialty of include discussion of the history of spinal procedures,
interventional radiology. Interventional radiology tra- review of the pharmacology of medications used
ditionally involves the treatment of vascular disease, in injection procedures, selective nerve root blocks,
but has grown to include nonvascular intervention and, epidural injections, facet injections, sacroiliac joint
recently, the treatment of spinal disorders. injections, discography, treatment of discogenic back
The objective of Interventional Radiology of the pain, spinal biopsy techniques, percutaneous verte-
Spine: Image-Guided Pain Therapy is to provide the broplasty, and transcatheter therapy for tumors of
practicing interventional radiologist with a single the spine.
source for evaluating and treating the patient with back The topics covered in this book should provide the
pain. This includes discussion of interventional spinal reader with a useful, comprehensive, state-of-the-art
procedures, spinal imaging, and the clinical evaluation reference on minimally invasive, image-guided spinal
of the spine patient. The practicing pain specialist will procedures, as well as a review of anatomy and imag-
also find this work useful because radiological spinal ing findings in spinal disorders. The hope is that
imaging is included, a topic most pain management Interventional Radiology of the Spine: Image-Guided
textbooks lack. Imaging has become an essential ele- Pain Therapy will allow more interventionalists to fully
ment in the evaluation of patients with back pain. employ the skill and expertise that they possess to the
The book is divided into two sections: Part I: Spi- evaluation and treatment of patients with back pain.
nal Anatomy, Imaging, and Clinical Evaluation; and J. Kevin McGraw, MD
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Acknowledgments
I would first like to acknowledge my parents. reason I attended the University of Virginia for radiol-
They instilled in me a strong work ethic and a desire ogy residency with the intent of doing an interven-
to succeed. They provided me with the firm founda- tional fellowship under his tutelage. I was fortunate to
tion on which my career has been built. My wife, have worked with him during residency until he met
Lisa, has been the cornerstone of my career. It was an untimely death during my fourth year. Had it not
her love and support that allowed me to survive been for Dr. Alan H. Matsumoto, I doubt that my
medical school, surgical internship, radiology career would have been as rewarding and successful
residency, and interventional fellowship. Our sons, as it is today. He taught me the technical skills and
Reed and Ryan, have given me the true meaning expertise to perform minimally invasive procedures,
for all of the years of hard work. I hope to make but more importantly, he provided me with a strong
all of their dreams come true, as my parents did clinical background in patient care. He emphasized
for me. that virtually anyone could be a technician and per-
I also wish to thank my mentors. As a medical stu- form procedures, but it took a physician to provide
dent, Dr. Stephen I. Schabel at the Medical University clinical care for the patient.
of South Carolina fostered my interest in diagnostic I would also like to acknowledge the contributors
radiology through his wit and intellect. He told me to this book who have toiled numerous hours prepar-
about interventional radiology when my interests ing their chapters. They have all done a remarkable
turned to the surgical subspecialties, but also encour- job. I would also like to thank my group members in
aged me to do a surgical internship prior to my resi- Riverside Radiology Associates for their unyielding
dency. Dr. Charles J. “Tunk” Tegtmeyer was the support in my professional endeavors.
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