53 The Use of Spinal Injections in Spinal Deformity Patients

Dilip K. Sengupta

Abstract

Surgical treatment for adult spinal deformity is complex and associated with high risk of complications and revisions. Various spinal injection procedures may be used as an extension of other non-operative treatment procedures to relieve symptoms and avoid the need for surgical treatment. When surgical intervention is unavoidable, various spinal injection procedures may help to identify the principal pain generator, and formulate an ideal surgical strategy for individual patient. The diagnostic and therapeutic role of various injection procedures including diskograms, epidural steroid injections, selective nerve root blocks, facet blocks, medial branch blocks, facet rhizotomy, etc. are discussed in this chapter.

Key words

LESI - diskogram - facet block - MBB - facet rhizotomy - RFNA - spinal deformity

• 1 Schwab F, Dubey A, Gamez L et al. Adult scoliosis: prevalence, SF-36, and nutritional parameters in an elderly volunteer population.. Spine 2005; 30 (9) 1082-1085 PubMed

• 2 Good CR, Auerbach JD, O’Leary PT, Schuler TC. Adult spine deformity.. Curr Rev Musculoskelet Med 2011; 4 (4) 159-167 PubMed

• 3 Sing DC, Berven SH, Burch S, Metz LN. Increase in spinal deformity surgery in patients age 60 and older is not associated with increased complications.. Spine J 2017; 17 (5) 627-635 PubMed

• 4 Akbarnia BA, Ogilvie JW, Hammerberg KW. Debate: degenerative scoliosis: to operate or not to operate.. Spine 2006; 31 (19) (Suppl. Suppl) S195-S201 PubMed

• 5 Sengupta DK. Spinopelvic balance.. JBJS Rev 2014; 2 (8) e4 PubMed

• 6 Nachemson AL. Proceedings: treatment of low back pain: a critical look at current methods.. J Bone Joint Surg Br 1975; 57 (2) 262 PubMed

• 7 Carragee EJ, Don AS, Hurwitz EL, Cuellar JM, Carrino JA, Herzog R. 2009 ISSLS Prize Winner: does discography cause accelerated progression of degeneration changes in the lumbar disc: a ten-year matched cohort study.. Spine 2009; 34 (21) 2338-2345 PubMed

• 8 Manchikanti L, Boswell MV, Singh V et al. Comprehensive review of neurophysiologic basis and diagnostic interventions in managing chronic spinal pain.. Pain Physician 2009; 12 (4) E71-E120 PubMed

• 9 Revel M, Poiraudeau S, Auleley GR et al. Capacity of the clinical picture to characterize low back pain relieved by facet joint anesthesia. Proposed criteria to identify patients with painful facet joints.. Spine 1998; 23 (18) 1972-1976, discussion 1977 PubMed

• 10 Manchikanti L, Pampati V, Fellows B, Baha AG. The inability of the clinical picture to characterize pain from facet joints.. Pain Physician 2000; 3 (2) 158-166 PubMed

• 11 Destouet JM, Gilula LA, Murphy WA, Monsees B. Lumbar facet joint injection: indication, technique, clinical correlation, and preliminary results.. Radiology 1982; 145 (2) 321-325 PubMed

• 12 Dreyfuss P, Schwarzer AC, Lau P, Bogduk N. Specificity of lumbar medial branch and L5 dorsal ramus blocks. A computed tomography study.. Spine 1997; 22 (8) 895-902 PubMed

• 13 Lord SM, Barnsley L, Bogduk N. The utility of comparative local anesthetic blocks versus placebo-controlled blocks for the diagnosis of cervical zygapophysial joint pain.. Clin J Pain 1995; 11 (3) 208-213 PubMed

• 14 Moscote-Salazar LR, Alvis-Miranda HR, Joaquim AF, Amaya-Quintero J, Padilla-Zambrano HS, Agrawal A. Sacroiliac pain: a clinical approach for the neurosurgeon.. J Neurosci Rural Pract 2017; 8 (4) 622-627 PubMed

• 15 Boswell MV, Trescot AM, Datta S, et al. Interventional techniques: evidence-based practice guidelines in the management of chronic spinal pain.. Pain Physician 2007; 10 (1) 7-111 PubMed

• 16 Singla A, Yang S, Werner BC et al. The impact of preoperative epidural injections on postoperative infection in lumbar fusion surgery.. J Neurosurg Spine 2017; 26 (5) 645-649 PubMed

• 17 Yang S, Werner BC, Cancienne JM et al. Preoperative epidural injections are associated with increased risk of infection after single-level lumbar decompression.. Spine J 2016; 16 (2) 191-196 PubMed

• 18 Bogduk N. The innervation of the lumbar spine.. Spine 1983; 8 (3) 286-293 PubMed

• 19 Shealy CN. Facet denervation in the management of back and sciatic pain.. Clin Orthop Relat Res 1976; (115) 157-164 PubMed

• 20 Leon JF, Ortiz JG, Fonseca EO, Martinez CR, Cuellar GO. Radiofrequency neurolysis for lumbar pain using a variation of the original technique.. Pain Physician 2016; 19 (3) 155-161 PubMed

• 21 Huang B, Yao M, Feng Z et al. CT-guided percutaneous infrazygomatic radiofrequency neurolysis through foramen rotundum to treat V2 trigeminal neuralgia.. Pain Med 2014; 15 (8) 1418-1428 PubMed

• 22 Jentzsch T, Sprengel K, Peterer L, Mica L, Werner CML. 3D navigation of endoscopic rhizotomy at the lumbar spine.. J Clin Neurosci 2016; 23: 101-105 PubMed

• 23 Andres RH, Graupner T, Bärlocher CB, Augsburger A, Fandino J. Laser-guided lumbar medial branch kryorhizotomy.. J Neurosurg Spine 2010; 13 (3) 341-345 PubMed

• 24 Li G, Patil C, Adler JR et al. CyberKnife rhizotomy for facetogenic back pain: a pilot study.. Neurosurg Focus 2007; 23 (6) E2 PubMed

• 25 van Kleef M, Barendse GA, Kessels A, Voets HM, Weber WE, de Lange S. Randomized trial of radiofrequency lumbar facet denervation for chronic low back pain.. Spine 1999; 24 (18) 1937-1942 PubMed

• 26 Birkenmaier C, Veihelmann A, Trouillier H et al. Percutaneous cryodenervation of lumbar facet joints: a prospective clinical trial.. Int Orthop 2007; 31 (4) 525-530 PubMed

• 27 Bärlocher CB, Krauss JK, Seiler RW. Kryorhizotomy: an alternative technique for lumbar medial branch rhizotomy in lumbar facet syndrome.. J Neurosurg 2003; 98 (1) (Suppl. Suppl) 14-20 PubMed

• 28 Martin BI, Mirza SK, Comstock BA, Gray DT, Kreuter W, Deyo RA. Are lumbar spine reoperation rates falling with greater use of fusion surgery and new surgical technology?. Spine 2007; 32 (19) 2119-2126 PubMed

• 29 Fritsch EW, Heisel J, Rupp S. The failed back surgery syndrome: reasons, intraoperative findings, and long-term results: a report of 182 operative treatments.. Spine 1996; 21 (5) 626-633 PubMed

• 30 Annertz M, Jönsson B, Strömqvist B, Holtås S. No relationship between epidural fibrosis and sciatica in the lumbar postdiscectomy syndrome. A study with contrast-enhanced magnetic resonance imaging in symptomatic and asymptomatic patients.. Spine 1995; 20 (4) 449-453 PubMed

• 31 Devulder J, Deene P, De Laat M, Van Bastelaere M, Brusselmans G, Rolly G. Nerve root sleeve injections in patients with failed back surgery syndrome: a comparison of three solutions.. Clin J Pain 1999; 15 (2) 132-135 PubMed

• 32 Devulder J. Transforaminal nerve root sleeve injection with corticosteroids, hyaluronidase, and local anesthetic in the failed back surgery syndrome.. J Spinal Disord 1998; 11 (2) 151-154 PubMed

• 33 Revel M, Auleley GR, Alaoui S et al. Forceful epidural injections for the treatment of lumbosciatic pain with post-operative lumbar spinal fibrosis.. Rev Rhum Engl Ed 1996; 63 (4) 270-277 PubMed

• 34 Manchikanti L, Pampati V, Fellows B, Rivera J, Beyer CD, Damron KS. Role of one day epidural adhesiolysis in management of chronic low back pain: a randomized clinical trial.. Pain Physician 2001; 4 (2) 153-166 PubMed

• 35 Sengupta DK. Adult spine deformity. In: Rao R, Smuck M, eds. Orthopaedic Knowledge Update: Spine. 4th ed. American Academy of Orthopaedic Surgeons; 2012:349–367