Ultrasound-guided procedures for the management of chronic thoracic back pain: a technical review

被引:0
作者
Nuno Ferreira-Silva
Rita Ribas
Mark Friedrich B. Hurdle
Sahil Gupta
Steven R. Clendenen
Guilherme Ferreira-Dos-Santos
机构
[1] Hospital Professor Doutor Fernando Fonseca,Department of Physical Medicine and Rehabilitation
[2] Centro Hospitalar Universitário de Lisboa Norte,Department of Anesthesiology
[3] Mayo Clinic,Department of Pain Medicine
[4] Mayo Clinic,Department of Anesthesiology and Perioperative Medicine
[5] University of Barcelona,Division of Pain Medicine, Department of Anesthesiology, Reanimation, and Pain Medicine, Hospital Clínic de Barcelona
来源
Journal of Ultrasound | 2024年 / 27卷
关键词
Chronic pain; Neuropathic pain; Pain medicine; Technical review; Thoracic pain;
D O I
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学科分类号
摘要
Pain arising from the thoracic region has been reported to be potentially as debilitating as cervical or lumbar back pain, and may stem from a vast number of spinal sources, including zygapophysial, costovertebral and costotransverse joints, intervertebral discs, ligaments, fascia, muscles, and nerve roots. Over the last two decades, the use of ultrasound in interventional spinal procedures has been rapidly evolving, due to the ultrasound capabilities of visualizing soft tissues, including muscle layers, pleura, nerves, and blood vessels, allowing for real-time needle tracking, while also reducing radiation exposure to both patient and physician, when compared to traditional fluoroscopy guidance. However, its limitations still preclude it from being the imaging modality of choice for some thoracic spinal procedures, notably epidural (interlaminar and transforaminal approaches) and intradiscal injections. In this technical review, we provide an overview of five thoracic spinal injections that are amenable to ultrasound guidance. We start by discussing their clinical utility, followed by the relevant topographic anatomy, and then provide an illustrated technical description of each of the procedures discussed: (1) erector spinae plane block; (2) intra-articular thoracic zygapophyseal (facet) joint injection; (3) thoracic medial branch block; (4) costotransverse joint injection; and (5) costovertebral joint injection.
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页码:1 / 11
页数:10
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