Epidural Injections 6. Sacroiliac Joint Injection 7. Percutaneous Spine Biopsy 8.
Image-Guided Spine Interventions
Vertebroplasty 9. Discography See All Customer Reviews. Shop Textbooks.
Add to Wishlist. USD Common procedures such as biopsy, epidural steroid injection and vertebroplasty or balloon assisted vertebroplasty are discussed. Newer procedures, such as sacroplasty, synovial cyst rupture, spinal cord stimulators, neurolysis, percutaneous discectomy, and minimally invasive treatment of spinal stenosis, are introduced. We are always looking for ways to improve customer experience on Elsevier. We would like to ask you for a moment of your time to fill in a short questionnaire, at the end of your visit.
Spine Interventional Radiology
If you decide to participate, a new browser tab will open so you can complete the survey after you have completed your visit to this website. Thanks in advance for your time. Dedicated chapters on bone biopsies, endovascular therapy of vascular disease, and implantable spinal cord stimulators are also questionably included, since these procedures fall outside the purview of most minimally invasive spine practices dedicated to pain management. One of the more informative chapters is by Dr.
The validity and utility of virtually every intervention addressed in subsequent chapters is often and appropriately called into question.
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Unfortunately, only 8 of references are from after , and no studies after are referenced. This contribution is arguably the most important of the book, and the reader deserves a more up-to-date treatment of these critical issues. This is an unfortunate failure on the part of the author and the editors.
In my own image-guided spine therapy practice, I am constantly amazed and gratified as patient after patient enters my office after months of misery and lost sleep and walks out miraculously pain-free. A recent highly recommended and fascinating account by Michael Spector details the history, beginning substantively with the work of Colonel Henry Beecher, the first chair of anesthesiology at MGH. Beecher was initially perplexed by the differential responses of gravely wounded soldiers who would recurrently refuse morphine versus healthy soldiers who would complain incessantly about pain from minor inconveniences like vaccinations.
He concluded, impressively, that our expectations have a profound impact on how we perceive pain and on how we heal. Indeed, the vertebroplasty versus sham RCTs previously mentioned are hardly unique, with analogous studies and similar results reported for chemonucleolysis, 4 intradiscal electrothermaltherapy IDET , 5 arthroscopic knee surgery, 6 and several other interventions.
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Indeed, objective physiological and neurological responses to placebos have been repeatedly observed using functional MRI, biochemical analyses, and may even be blocked pharmacologically using receptor antagonists to endogenous opiods. As a profession moving forward we must not be afraid to ask the hardest questions, even in the face of apparently obvious therapeutic efficacy, and work towards a solid foundation of evidence-based rather than anecdotal or economically driven clinical decision-making.