Interventional Approaches to Chronic Pain: Blocks, Stimulators, Pumps. Background. Neurosurgical ablative treatments for pain since 19th century but now infrequently used Ablation eclipsed by percutaneous injections or therapies that target central or peripheral pathways Nerve blocks
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Interventional Approachesto Chronic Pain:Blocks, Stimulators, Pumps
Reproduced with permission from Simons DG, et al. Travell & Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual. Vol. 1. 2nd ed. Philadelphia, Pa: Williams & Wilkins; 1999:160.
Reproduced with permission from Simons DG, et al. Travell & Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual. Vol. 1. 2nd ed. Philadelphia, Pa: Williams & Wilkins; 1999:159.
Reproduced with permission from Covino BG, Scott DB. Handbook of Epidural Anaesthesia and Analgesia. New York, NY: Grune & Stratton, Inc; 1985:90.
Sacral Extradural Injection
Reproduced with permission from Eriksson E, ed. Illustrated Handbook in Local Anaesthesia. 2nd ed. London, Eng: Lloyd-Luke (Medical Books) Ltd; 1979:135.
Layering of Contrast in Epidural Space (C5-6 Epidural)
C 3-4 Facet Injection (Lateral View)
S1 Root Block (Trans-Sacral)
Lumbar Sympathetic Block (Lateral View)
Celiac Block (Lateral View)
CT-Guided Celiac Block
*See Carr DB, Cousins MJ. Spinal route of analgesia. Opioids and future options. In: Neural Blockade in Clinical Anesthesia and Management of Pain. 3rd ed. Philadelphia, Pa: Lippincott-Raven; 1998:915-983.
*See Walker S, et al. Anesth Analg. In press.
*See Bennett G, et al. J Pain Symptom Manage. 2000;20:S37-S43.