Learning objectives
To depict spinal anatomy and potential pain sources
To overview image findings in lumbosacracal spinal pain
To establish an appropiate management for this patients
To show therapeutic injections techniques forlow back pain.
Background
The lumbosacral spine is the source of pain,
suffering,
and disability more frequently than anyother part of the body.When low back pain does not improve with conservative management,
the cause of the pain must be determined before further therapy is initiated.After a symptomatic structure has been identified,
therapeutic spinal injections may be administered as an adjunct to conservative management,
especially in patients with inoperable conditions.
ANATOMY
OSSEOUS STRUCTURES
The lumbar vertebra has anterior elements (consisting of the vertebral bodies),
middle elements (consisting of the pedicles),...
Findings and procedure details
IMAGING IN PROCEDURAL SELECTION
Symptom-imaging correlation guides procedural selection and planning.
It enables one to verify the appropriateness of the requested intervention or justify modification.
Procedural selection begins with a judgment on the pain generator.
The symptom-imaging correlation exercise is to interview the patient before we review the MR images,
and then deduce the most likely pain generator and predict the MR imaging findings.
Other variation is reviewing the MR images before the interview of the patient,
so it is posibble to deduce the most...
Conclusion
Low back pain is a common and debilitating condition necessitating proper clinical and imaging evaluation for identifying the potential pain source in order to be treated.
The interventional radiologist has an active role to play in minimally invasive management of lower back pain and should be part of an interdisciplinary team that determines the appropriate therapy.
Imaging apart from contributing to the diagnostic evaluation,
provides guidance for therapeutic injections techniques,
increasing technical efficacy and minimizing potential complications rate.
References
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