Lippincotts Concise Illustrated Anatomy: Back, Upper Limb and Lower Limb

The key to safety and success of any interventional pain technique is a clear understanding of normal anatomy. The procedures described in this chapter require an understanding of the normal anatomy of the spine, including the epidural and subarachnoid spaces, zygapophyseal joints, intervertebral disks, and, most importantly, the spinal cord with its somatic and sympathetic components. Epidural steroid injections are efficacious in the treatment of acute lumbosacral radicular pain and radiculopathies secondary to herniated intervertebral disks.

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Epidural steroid injections also have been used to treat back pain secondary to degenerative disk disease, spinal stenosis, trauma, spondylolysis or spondylolisthesis, and in pain following laminectomy. The epidural space can be approached through the interlaminar space median or paramedian , intervertebral foramen transforaminal , or sacral hiatus caudal.

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We are still lacking large-scale studies comparing clinical outcomes with the transforaminal versus the interlaminar approach. Many practitioners continue to use sympathetic blockade as part of a multidisciplinary approach to treating complex regional pain syndrome. Sympathetic blocks provide one tool that can reduce pain and facilitate functional recovery. Intraarticular facet injection has been largely supplanted by radiofrequency treatment techniques for facet-related pain.

Clinical experience and a limited number of published observational studies suggest that intraarticular injection of local anesthetic and steroid leads to relief of facet-related pain that is of limited duration. In contrast, radiofrequency treatment is safe and effective in producing longer-term pain relief in the same group of patients.

Lippincott Concise Illustrated Anatomy: Back, Upper Limb and Lower Limb

Diskography is a diagnostic test in which radiographic contrast is injected into the nucleus pulposus of the intervertebral disk. Although originally developed for the study of disk herniation, diskography now is used most commonly to identify symptomatic disk degeneration. The usefulness of this diagnostic test remains controversial and has dramatically declined in recent years because of fears that the test itself may accelerate disk degeneration.

Intrathecal morphine and other opioids are now widely used as adjuncts in the treatment of acute and chronic pain, and a number of agents show promise as analgesic agents with spinal selectivity. Patient selection for intraspinal pain therapy is empiric and remains Please enter User Name Password Error: Please enter Password Forgot Username? Use this site remotely Bookmark your favorite content Track your self-assessment progress and more! April New R May New Rel Back to School Sale.

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Promocode will not apply for this product. Products purchased from 3rd Party sellers are not guaranteed by the Publisher for quality, authenticity, or access to any online entitlements included with the product. The unique regional focus of the series facilitates teaching and learning in semester or year-long anatomy systems blocks.

This volume on the back, upper limb and lower limb aligns with the musculoskeletal systems block. Two forthcoming volumes in the series--Thorax, Abdomen, and Pelvis and Head and Neck--cover other regions in depth.

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Lippincott's Concise Illustrated Anatomy. About The Author s. Cervical and Thoracic 1. Lumbar, Sacrum, and Coccyx 1.