thoracic interventions.ppt
TRANSCRIPT
Thoracic InterventionsThoracic InterventionsAndrea Trescot, MDAndrea Trescot, MD
pedicle
pedicle
pedicles
spinous process
spinous process
spinous process
Rib articulation
nerve root
Thoracic Epidural Technique
• Position prone• Identify interspace• Tuohy needle (17 to
20g)• Advance to bone• Drop into interspace• Loss of resistance to
saline• Inject nonionic
contrast
Thoracic Epidural Indications
• Thoracic radiculopathy• Intercostal neuralgia• Shingles• Compression fracture• Perioperative pain (?catheter)
– Breast surgery– Thoracotomy– Upper abdominal surgery
• Pancreatitis• Access for SCS
Transforaminal Epidural
Thoracolumbar DRG
Thoracic Facet Joint Nerves
Intra-articular Thoracic Facet
Thoracic Facet Medial Branch Block
RF Thoracic Facet
Thoracic Sympathetic
Thoracic Sympathetic
RF Thoracic Sympathetic
Thoracic Discogram
Costovertebral Joint
Spinous Process
Vertebral body
Transversecostal facet
Vertebral costal facet
CT Costovertebral Injection
Spinal Cord Stimulation
Thoracic Vertebroplasty
Other Thoracic Techniques
Other Thoracic Techniques Peripheral Stimulation
Other Thoracic Techniques12th Rib
Other Thoracic TechniquesIntercostal
Other Thoracic TechniquesTrigger Point Injections
Other Thoracic TechniquesIntercostal Nerve Block
Other Thoracic TechniquesCryoneuroablation Intercostal
Other Thoracic TechniquesProlotherapy (RIT)
Thorax“The forgotten spine”
Thank You