Interventional Procedures of the Spine

Abstract

Different interventional procedures performed under imaging guidance permit the diagnosis and treatment of the many causes of back pain. Sources of pain amenable to be treated include facet joints, vertebral body, intervertebral disk, and paraspinal structures including nerves and ganglion roots. These procedures may be merely diagnostic, therapeutic, or intended for both purposes. We review the main indications, advantages, and complications of these techniques.

Keywords

spine - interventional radiology - imaging guidance

• References

• 1 Ruiz Santiago F, Castellano García MdelM, Aparisi Rodríguez F. Papel de la radiología intervencionista en el diagnóstico y tratamiento de la columna vertebral dolorosa. Med Clin (Barc) 2013; 140 (10) 458-465
• 2 Kelekis AD, Somon T, Yilmaz H , et al. Interventional spine procedures. Eur J Radiol 2005; 55 (3) 362-383
• 3 Gallucci M, Limbucci N, Paonessa A, Splendiani A. Degenerative disease of the spine. Neuroimaging Clin N Am 2007; 17 (1) 87-103
• 4 Colen S, Haverkamp D, Mulier M, van den Bekerom MP. Hyaluronic acid for the treatment of osteoarthritis in all joints except the knee: what is the current evidence?. BioDrugs 2012; 26 (2) 101-112
• 5 Staal JB, de Bie RA, de Vet HC, Hildebrandt J, Nelemans P. Injection therapy for subacute and chronic low back pain: an updated Cochrane review. Spine 2009; 34 (1) 49-59
• 6 Manchikanti L, Abdi S, Atluri S , et al. An update of comprehensive evidence-based guidelines for interventional techniques in chronic spinal pain. Part II: guidance and recommendations. Pain Physician 2013; 16 (2, Suppl): S49-S283
• 7 Weeks EM, Platt MW, Gedroyc W. MRI-guided focused ultrasound (MRgFUS) to treat facet joint osteoarthritis low back pain—case series of an innovative new technique. Eur Radiol 2012; 22 (12) 2822-2835
• 8 Varlotta GP, Lefkowitz TR, Schweitzer M , et al. The lumbar facet joint: a review of current knowledge: Part II: diagnosis and management. Skeletal Radiol 2011; 40 (2) 149-157
• 9 Ruiz Santiago F, Guzmán Álvarez L, Castellano García MM. Computed tomography based interventional radiology in the musculoskeletal system. In: Suri JS. ed. Multi-Detector CT Imaging Abdomen, Pelvis, and CAD Applications. Boca Raton, FL: CRC Press; 2013: 475-494
• 10 Bogduk N, Dreyfuss P, Govind J. A narrative review of lumbar medial branch neurotomy for the treatment of back pain. Pain Med 2009; 10 (6) 1035-1045
• 11 Cohen SP, Strassels SA, Kurihara C , et al. Establishing an optimal “cutoff” threshold for diagnostic lumbar facet blocks: a prospective correlational study. Clin J Pain 2013; 29 (5) 382-391
• 12 Nourbakhsh A, Grady JJ, Garges KJ. Percutaneous spine biopsy: a meta-analysis. J Bone Joint Surg Am 2008; 90 (8) 1722-1725
• 13 Sehn JK, Gilula LA. Percutaneous needle biopsy in diagnosis and identification of causative organisms in cases of suspected vertebral osteomyelitis. Eur J Radiol 2012; 81 (5) 940-946
• 14 Jaramillo-de la Torre JJ, Bohinski RJ, Kuntz IV C. Vertebral osteomyelitis. Neurosurg Clin N Am 2006; 17 (3) 339-351 , vii
• 15 Xing D, Ma JX, Ma XL , et al. A meta-analysis of balloon kyphoplasty compared to percutaneous vertebroplasty for treating osteoporotic vertebral compression fractures. J Clin Neurosci 2013; 20 (6) 795-803
• 16 Rousing R, Hansen KL, Andersen MO, Jespersen SM, Thomsen K, Lauritsen JM. Twelve-months follow-up in forty-nine patients with acute/semiacute osteoporotic vertebral fractures treated conservatively or with percutaneous vertebroplasty: a clinical randomized study. Spine 2010; 35 (5) 478-482
• 17 Farrokhi MR, Alibai E, Maghami Z. Randomized controlled trial of percutaneous vertebroplasty versus optimal medical management for the relief of pain and disability in acute osteoporotic vertebral compression fractures. J Neurosurg Spine 2011; 14 (5) 561-569
• 18 Santiago FR, Abela AP, Alvarez LG, Osuna RM, García MdelM. Pain and functional outcome after vertebroplasty and kyphoplasty. A comparative study. Eur J Radiol 2010; 75 (2) e108-e113
• 19 Hiwatashi A, Westesson PLA, Yoshiura T , et al. Kyphoplasty and vertebroplasty produce the same degree of height restoration. AJNR Am J Neuroradiol 2009; 30 (4) 669-673
• 20 Carlier RY, Gordji H, Mompoint DM, Vernhet N, Feydy A, Vallée C. Osteoporotic vertebral collapse: percutaneous vertebroplasty and local kyphosis correction. Radiology 2004; 233 (3) 891-898
• 21 Chen LH, Hsieh MK, Liao JC , et al. Repeated percutaneous vertebroplasty for refracture of cemented vertebrae. Arch Orthop Trauma Surg 2011; 131 (7) 927-933
• 22 Pflugmacher R, Taylor R, Agarwal A , et al. Balloon kyphoplasty in the treatment of metastatic disease of the spine: a 2-year prospective evaluation. Eur Spine J 2008; 17 (8) 1042-1048
• 23 Bouza C, López-Cuadrado T, Cediel P, Saz-Parkinson Z, Amate JM. Balloon kyphoplasty in malignant spinal fractures: a systematic review and meta-analysis. BMC Palliat Care 2009; 8: 12
• 24 Masala S, Fiori R, Massari F, Simonetti G. Vertebroplasty and kyphoplasty: new equipment for malignant vertebral fractures treatment. J Exp Clin Cancer Res 2003; 22 (4, Suppl): 75-79
• 25 Rotter R, Martin H, Fuerderer S , et al. Vertebral body stenting: a new method for vertebral augmentation versus kyphoplasty. Eur Spine J 2010; 19 (6) 916-923
• 26 Anselmetti GC, Manca A, Tutton S , et al. Percutaneous vertebral augmentation assisted by PEEK implant in painful osteolytic vertebral metastasis involving the vertebral wall: experience on 40 patients. Pain Physician 2013; 16 (4) E397-E404
• 27 Adachi A, Kaminou T, Ogawa T , et al. Heat distribution in the spinal canal during radiofrequency ablation for vertebral lesions: study in swine. Radiology 2008; 247 (2) 374-380
• 28 Martel J, Bueno A, Nieto-Morales ML, Ortiz EJ. Osteoid osteoma of the spine: CT-guided monopolar radiofrequency ablation. Eur J Radiol 2009; 71 (3) 564-569
• 29 Ruiz Santiago F, Castellano García MdelM, Guzmán Álvarez L, Martínez Montes JL, Ruiz García M, Tristán Fernández JM. Percutaneous treatment of bone tumors by radiofrequency thermal ablation. Eur J Radiol 2011; 77 (1) 156-163
• 30 Gangi A, Buy X. Percutaneous bone tumor management. Semin Intervent Radiol 2010; 27 (2) 124-136
• 31 Gangi A, Tsoumakidou G, Buy X, Quoix E. Quality improvement guidelines for bone tumour management. Cardiovasc Intervent Radiol 2010; 33 (4) 706-713
• 32 Rosenthal D, Callstrom MR. Critical review and state of the art in interventional oncology: benign and metastatic disease involving bone. Radiology 2012; 262 (3) 765-780
• 33 Carrafiello G, Laganà D, Pellegrino C , et al. Percutaneous imaging-guided ablation therapies in the treatment of symptomatic bone metastases: preliminary experience. Radiol Med (Torino) 2009; 114 (4) 608-625
• 34 Bonetti M, Fontana A, Cotticelli B, Volta GD, Guindani M, Leonardi M. Intraforaminal O(2)-O(3) versus periradicular steroidal infiltrations in lower back pain: randomized controlled study. AJNR Am J Neuroradiol 2005; 26 (5) 996-1000
• 35 Glaser SE, Shah RV. Root cause analysis of paraplegia following transforaminal epidural steroid injections: the 'unsafe' triangle. Pain Physician 2010; 13 (3) 237-244
• 36 Kelekis AD, Filippiadis DK, Martin JB, Brountzos E. Standards of practice: quality assurance guidelines for percutaneous treatments of intervertebral discs. Cardiovasc Intervent Radiol 2010; 33 (5) 909-913
• 37 Amoretti N, Huwart L, Marcy PY, Foti P, Hauger O, Boileau P. CT- and fluoroscopy-guided percutaneous discectomy for lumbar radiculopathy related to disc herniation: a comparative prospective study comparing lateral to medial herniated discs. Skeletal Radiol 2013; 42 (1) 49-53
• 38 Nagae M, Ikeda T, Mikami Y , et al. Intervertebral disc regeneration using platelet-rich plasma and biodegradable gelatin hydrogel microspheres. Tissue Eng 2007; 13 (1) 147-158
• 39 Chan SC, Gantenbein-Ritter B. Intervertebral disc regeneration or repair with biomaterials and stem cell therapy—feasible or fiction?. Swiss Med Wkly 2012; 142: w13598
• 40 Erginousakis D, Filippiadis DK, Malagari A , et al. Comparative prospective randomized study comparing conservative treatment and percutaneous disk decompression for treatment of intervertebral disk herniation. Radiology 2011; 260 (2) 487-493
• 41 Lindblom K. Diagnostic puncture of intervertebral disks in sciatica. Acta Orthop Scand 1948; 17 (3–4) 231-239
• 42 Wise RE, Weiford EC. X-ray visualization of the intervertebral disc. Cleve Clin J Med. 1951; 18: 127-130
• 43 Guyer RD, Ohnmeiss DD. Lumbar discography. Position statement from the North American Spine Society diagnostic and therapeutic committee. Spine 1995; 20 (18) 2048-2059
• 44 Filippiadis DK, Mazioti A, Papakonstantinou O , et al. Quantitative discomanometry: correlation of intradiscal pressure values to pain reduction in patients with intervertebral disc herniation treated with percutaneous, minimally invasive, image-guided techniques. Cardiovasc Intervent Radiol 2012; 35 (5) 1145-1153
• 45 Shah RV, Everett CR, McKenzie-Brown AM, Sehgal N. Discography as a diagnostic test for spinal pain: a systematic and narrative review. Pain Physician 2005; 8 (2) 187-209
• 46 Kelekis A, Filippiadis DK, Wilhelm K, Martin JB. Interventional therapy of the intervertebral disc. In: Mahnken AH, Wilhelm KE, Ricke J, , eds. CT- and MR-Guided Interventions in Radiology. Berlin, Germany: Springer; 2013: 406-412
• 47 Kelekis A, Filippiadis D. Percutaneous therapy versus surgery in chronic back pain: how important is imaging in decision-making?. Imaging Med 2013; 5 (2) 187-196
• 48 Yoshikawa T, Hayashi N, Yamamoto S , et al. Brachial plexus injury: clinical manifestations, conventional imaging findings, and the latest imaging techniques. Radiographics 2006; 26 (Suppl. 01) S133-S143
• 49 Williams AL . Myelography. In: Williams AL, Murtagh FR, eds. Handbook of Diagnostic and Therapeutic Spine Procedures. St. Louis, MO: CV Mosby; 2002: 107-129
• 50 Dinç H, Ahmetoğlu A, Baykal S, Sari A, Sayil O, Gümele HR. Image-guided percutaneous drainage of tuberculous iliopsoas and spondylodiskitic abscesses: midterm results. Radiology 2002; 225 (2) 353-358