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Spinal Injections for Pain
Management
Autores: William E. Palmer, MD
Se analiza una serie de 6 pacientes en forma retrospectiva portadores de masas pulmonares con contacto parietal, que fueron pasibles de ser puncionados bajo método ecográfico por vía percutánea, con el objetivo de arribar a un diagnóstico anatomo-patológico.
Se enfatiza el rol de ésta técnica de imagen en pacientes seleccionados, analizando los resultados obtenidos, destacando de la misma su accesibilidad y la no utilización de radiaciones ionizantes.
El rendimiento diagnóstico obtenido fue excelente, lográndose en todos los casos arribar a una muestra de tejido suficiente para su análisis, sin un incremento de las complicaciones del procedimiento.
Palabras clave Tórax, Biopsia, Ultrasonido, Diagnóstico.
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Image-guided spinal injection is commonly performed in
symptomatic patients to decrease pain severity, confirm
the pain generator, and delay or avoid surgery. This article
focuses on the radiologist as spine interventionist and
addresses the following four topics relevant to the radiologist
who performs corticosteroid injections for pain management:
(a) the rationale behind corticosteroid injection,
(b) the interaction with patients, (c) the role of imaging
in procedural selection and planning, and (d) the pearls
and pitfalls of fluoroscopically guided injections. Factors
that contribute to the success of a pain management service
include communication skills and risk mitigation. A
critical factor is the correlation of clinical symptoms with
magnetic resonance (MR) imaging findings. Radiologists
can leverage their training in MR image interpretation to
distinguish active pain generators in the spine from incidental
abnormalities. Knowledge of fluoroscopic anatomy
and patterns of contrast material flow guide the planning
and execution of safe and effective needle placement.
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