Nonoperative interventions for spinal pain.
10.5124/jkma.2014.57.4.308
- Author:
Dong Ah SHIN
1
;
Hyoung Ihl KIM
Author Information
1. Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. shindongah@me.com
- Publication Type:Original Article
- Keywords:
Pain management;
Spine;
Injections;
Review
- MeSH:
Decision Making;
Diagnosis;
Humans;
Nerve Block;
Neurologic Examination;
Neurologic Manifestations;
Pain Management;
Radiculopathy;
Sacroiliac Joint;
Spine
- From:Journal of the Korean Medical Association
2014;57(4):308-317
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Spinal pain is a common symptom that motivates visiting a physician. However, the natural course is usually benign and few patients need invasive treatment. Even though history taking, neurological examination, and imaging studies provide useful information for understanding the etiology of spinal pain, the pain chart is the most important tool for decision making regarding spinal interventions. Invasive treatments for chronic spinal pain refractory to conservative management include surgery as well as established interventions such as medial branch blocks, nerve root blocks, the sacroiliac joint block, and radiofrequency neurotomy, as well as emerging procedures such as pressure-controlled discography and percutaneous epidural adhesiolysis. Surgery should be considered for patients with a progressive neurologic deficit including significant radiculopathy, failure of spinal interventions, or an uncertain or serious diagnosis.
