Treatment Articles for Spine Professionals

Chronic Pain Update: Ziconotide - A New Class of Pharmacologic Agent

Ziconotide is the first FDA-approved agent in a promising class of drugs called the conotoxins. Its release carried the specific indication for intrathecal use in chronic pain patients.

Indications, Risks, and Contraindications: Epidural Corticosteroid Injections

A review of the indications, risks, and contraindications for epidural steroid injections including study results.

Minimally Invasive Transforaminal Lumbar Interbody Fusion (TLIF): Technical Feasibility and Initial Results

An abstract describing the use and results of minimally invasive TLIF techniques.

Precision Injection Techniques for Diagnosis and Treatment of Lumbar Disc Disease: The Next Step

Precision spine injections are potentially powerful tools for both diagnosing and treating the anatomic source of chronic spinal pain.

Epidural Corticosteroid Injections: Technical Considerations - Part B

Various routes for administration of epidural steroids are discussed; figures included.

Epidural Corticosteroid Injections: Technical Considerations, Part A

Fluoroscopic guidance and contrast medium greated increase the accuracy and safety of epidural steroid injections.

Epidural Corticosteroid Injections: Conclusion

Epidural steroid injections have a role in radicular pain, as proven with some controlled and many uncontrolled studies, including meta-anaylses.

References: When, How, and Why to Use Epidural Corticosteroid Injections: An Overview

References for the article "When, How, and Why to Use Epidural Corticosteroid Injections."

Procedural Safety Guidelines for Cervical Epidural Steroid Injections: Appendix 1: Part A

Safety guidelines for cervical epidural steroid injections.

When, How, and Why to Use Epidural Corticosteroid Injections: An Overview

Spinal epidural steroid injections are commonly utilized in the treatment of acute spinal pain and may provide diagnostic confirmation of a specific "pain generator."

Procedural Safety Guidelines for Cervical Epidural Steroid Injections: Appendix 1 - Part B

Part B of Appendix 1 that outlines safety guidelines for cervical epidural steroid injections.

Selective Epidural Injection: Section 1

A selective epidural injection is a variation of the selective nerve root injection.

Selective Epidural Injection: Section 2

A selective epidural approach ensures that the injection incorporates all the sites where pathology can affect the nerve.

A Discussion of the Trans1 AxiaLIF

Doctor Larry T. Khoo, CoDirector of the Comprehensive Spine Center in Santa Monica discusses the Trans1 AxiaLIF® surgical procedure.

References: Direct Lateral Transpsoas Approach

The list of References to Dr. Reginald Knight's article about the minimally invasive lumbar interbody fusion procedure, DLIF or Direct Lateral Transpsoas Approach.

Discussion: Direct Lateral Transpsoas Approach

Direct lateral transpsoas lumbar interbody fusion may prove to be an important improvement in our methods of handling degenerative conditions affecting the lumbar spine.

Direct Lateral Transpsoas Lumbar Approach

A less invasive direct lateral transpsoas approach to the lumbar spine has proved to be an effective method of managing patients requiring interbody fusion of the mid-lumbar spine.

Results: Direct Lateral Transpsoas Approach

DLIF complications that altered the discharge plan or patient function, occured in 10 out of 38 patients. Two tables detail these complications.

Procedure Description: Direct Lateral Transpsoas Lumbar Interbody Fusion

Doctor Reginald Knight describes the direct lateral transpsoas lumbar interbody fusion procedure. Included are several intraoperative images.

TLIF: Bone Grafts and Structural Implants

There are various devices that can be used as structural grafts and implants. However, the ideal standard of care is to provide an interbody fusion with iliac crest bone graft harvested from the patient at the time of surgery.

TLIF: Distraction, Annulotomy, Endplate Preparation, and Interbody Template Use

A review of the surgical distraction techniques, annulotomy and endplate preparation, and interbody template use.

TLIF: Indications for Pseudoarthrosis

The risks of distrction involve an inadvertent injury to the dorsal root ganglion, fracture of the bony anatomy, and neural injury to the midline dura due to manipulation.

Transforaminal Lumbar Interbody Fusion (TLIF): Advantages

One of the greatest advantages of TLIF is the working zone within the disc space.

Transforaminal Lumbar Interbody Fusion (TLIF) Technique

The added biological advantage of an interbody fusion technique with compression across a structural fusion cage or apparatus will add to the success of a lumbar arthrodesis procedure.

Percutaneous Transforaminal Endoscopic Spine Surgery: Introduction - Part 1

Endoscopic spine surgery is evolving rapidly due to improvements in surgical technique, endoscopic design, and instrumentation.

Potential Complications and Avoidance: Part 3

As with arthroscopic knee surgery, the risks of serious complications or injury are low; approximately 1% or less in the author's experience.

Summary and References: Part 4

Endoscopic spine surgery has a high learning curve, but is within the grasp of every endoscopic surgeon with proper training.

Indications for Foraminal Endoscopic Surgery: Part 2

Most disc herniations are amenable to endoscopic disc excision and the timing of surgical treatment is similar to transcanal discectomy.

Rationale: How, When, and Why to Use Epidural Corticosteroid Injections

There is an ongoing trend toward non-surgical management of disc herniations with or without radiculopathy.
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