Interventional spinal procedures in musculoskeletal radiology: Role in pain management

Image-guided procedures have seen explosive growth in the past decade, and spinal interventional procedures directed at back pain are no exception. These interventions may provide valuable diagnostic information regarding the source of the patient's pain, and in many cases provide therapeutic relief of symptoms. Examples of these procedures are facet joint injections, selective and nonselective epidural injections, sacroiliac joint injections, and vertebroplasty. This article discusses general considerations surrounding these techniques, including medication selection. Technical aspects of each procedure are described in detail, with separate discussions of the cervical, thoracic, and lumbar spine applications. While not intended as a substitute for formal training, this information is designed to serve as a reference for both practitioners new to spinal intervention as well as more experienced operators.