The expert knowledge on numerous established and innovative minimally invasive interventions on the spine is systematically and in detail summarized in this book. All chapters are consistently structured with special education, implementation of the intervention, complications, literature, reimbursement and a final conclusion with assessment of clinical relevance. The focus is on the practice: step-by-step the procedure is presented under the heading "carrying out the intervention".
The book is ideal for practitioners who want to benefit from the know-how of experienced colleagues or who are interested in new innovative procedures and for referring physicians who want to get an overview.
This book is a translation of the original German 1st edition Minimalinvasive Wirbelsäulenintervention by Jerosch Jörg published by Springer-Verlag GmbH Germany, part of Springer Nature in 2019. The translation was done with the help of artificial intelligence (machine translation by the service DeepL.com). A subsequent human revision was done primarily in terms of content, so that the book will read stylistically differently from a conventional translation. Springer Nature works continuously to further the development of tools for the production of books and on the related technologies to support the authors.
Author(s): Jörg Jerosch
Publisher: Springer
Year: 2023
Language: English
Pages: 361
City: Berlin
Foreword
Preface
Contents
Contributors
Abbreviations
1: Billing Proposals for Interventional Procedures on the Spine
1.1 The Bielefeld Settlement Table of the Professional Association of German Neurosurgeons
Reference
2: Interdisciplinary Multimodal Inpatient Pain Therapy
2.1 Introduction and Definition
2.2 Interdisciplinary Multimodal Assessment
2.3 Therapy Contents of the Interdisciplinary Multimodal Pain Therapy
2.3.1 Special Medical Tasks
2.3.2 Psychotherapeutic Aspects of Treatment
2.3.3 Exercise Therapy
2.3.4 Algesiological Specialist Assistance
2.3.5 Results
2.4 Supply Structures
2.5 Quality Assurance
2.6 Conclusion and Outlook
References
3: Treatment Algorithm for Neuropathic Pain Syndrome
3.1 Introduction
3.2 Epidemiological Data
3.3 Diagnosis of Neuropathic Pain
3.4 Therapy of Neuropathic Pain
3.4.1 Pharmacotherapy
3.4.2 Psychotherapy
3.4.3 Physical and Occupational Therapy
3.4.4 Interventional and Neuromodulatory Therapies
3.4.5 Therapy Algorithm
References
4: Landmark-Assisted Infiltrations and Injection Techniques on the Cervical, Thoracic and Lumbar Spine
4.1 Introduction
4.2 Indication
4.3 Preinterventional Diagnostics
4.4 Necessary Instruments
4.5 Pre-Intervention Education
4.6 Special Neuroanatomy of the Cervical, Thoracic and Lumbar Spine
4.7 Implementation of the Interventions
4.7.1 Cervical Spinal Nerve Analgesia (CSPA/Cervical PRT)
4.7.2 Cervical Facet Infiltration (Fac. Cervical)
4.7.3 Conclusion and Clinical Relevance of Injection Therapy in the Cervical Spine
4.7.4 Thoracic Facet Infiltration (Fac. Thoracic)
4.7.5 Conclusion and Clinical Relevance of Injection Therapy in the Thoracic Spine
4.7.6 Lumbar Spinal Nerve Analgesia (LSPA/Lumbar PRT)
4.7.7 Lumbar Facet Infiltration (Fac. Lumbal)
4.7.8 Ligamentous Infiltration at the Sacroiliac Joint (SIG Block)
4.7.9 Epidural Dorsal Injection (Epi Dorsal/Epi Straight)
4.7.10 Epidural Perineural Injection (Epi Peri)
4.7.11 Conclusion and Clinical Relevance of Injection Therapy in the Lumbar Spine
4.8 Possible Complications
4.9 Results in the Literature
4.9.1 Facet/SIG Infiltrations
4.9.2 Epidural/Periradicular/Transforaminal Injections
4.10 Reimbursement of Costs
4.10.1 Private Medical Reimbursement (GOÄ)
4.10.2 Reimbursement by Statutory Health Insurance Physicians (EBM)
4.11 Conclusion and Clinical Relevance
References
5: Radiation Protection and C-Arm Operation
5.1 Introduction
5.2 Biological Effects of Ionising Radiation
5.3 Dose Guideline Values and Dose Determination
5.4 C-Arm Technique
5.5 Dose Values for Mobile Intraoperative Fluoroscopy
5.6 Radiation Protection
5.6.1 Residence Time
5.6.2 Activity
5.6.3 Distance
5.6.4 Shielding (Radiation Protection Material)
5.6.5 Training
5.6.6 Quality Assurance
5.6.7 Hygiene and Sterility
5.6.8 Equipment
5.7 Conclusion
References
6: Treatment of Refractory Myofascial Pain of the Neck and Shoulder Girdle with Botulinum Toxin A
6.1 Introduction
6.2 Literature Research
6.3 Discussion of the Study Results
6.4 Practical Conclusions and Overall Therapy Concept
References
7: Lumbar Facet Joint Injection and Radiofrequency Denervation
7.1 Indication
7.2 Preinterventional Diagnostics
7.3 Necessary Instruments
7.4 Pre-Intervention Education
7.5 Implementation of the Intervention
7.5.1 Spatial Requirements
7.5.2 Preliminary Anatomical Remarks
7.5.3 Technical Execution of the Injection at the Ramus Medialis
7.5.4 Technical Implementation of Radiofrequency Denervation
7.6 Possible Complications
7.7 Results in the Literature
7.7.1 Impact on the Latest Guidelines
7.8 Conclusion and Clinical Relevance
References
8: Cervical Radiofrequency Therapy
8.1 Indication
8.2 Preinterventional Diagnostics
8.2.1 Diagnostic Blockade of the Medial Ramus
8.3 Necessary Instruments
8.4 Pre-Intervention Education
8.5 Implementation of the Intervention
8.5.1 Storage
8.5.2 General Procedure
8.5.3 Procedure for C3–C6
8.5.4 Procedure for C7
8.5.5 Procedure for the Third Occipital Nerve
8.5.6 Procedure in New Technology
8.6 Possible Complications
8.7 Results in the Literature
8.8 Reimbursement of Costs
8.9 Conclusion and Clinical Relevance
References
9: Cervical Epidural Injection
9.1 Introduction and Indication
9.2 Necessary Instruments
9.3 Pre-Intervention Education
9.4 Implementation of the Intervention
9.4.1 Transforaminal Injection
9.4.2 Interlaminar Injection
9.4.3 Performance Parameters
9.4.4 Post-Intervention Observation and Instruction
9.4.5 Summary
9.5 Possible Complications
9.6 Results in the Literature
References
10: Lumbar Epidural Injection
10.1 Introduction and Indication
10.2 Necessary Instruments
10.3 Pre-Intervention Education
10.4 Implementation of the Intervention
10.4.1 Transforaminal Injection
10.4.2 Interlaminar Injection
10.4.3 Performance Parameters
10.4.4 Post-Intervention Observation and Instruction
10.4.5 Summary
10.5 Possible Complications
10.6 Results in the Literature
References
11: Sensory Innervation of the Sacroiliac Joint
11.1 Introduction
11.2 Biology
11.3 Joint Anatomy
11.4 Biomechanics
11.5 Innervation
References
12: Radiofrequency Denervation of the Sacroiliac Joint
12.1 Indication and Prevalence
12.2 Preinterventional Diagnostics
12.3 Necessary Instruments
12.4 Pre-Intervention Education
12.5 Implementation of the Intervention
12.6 Possible Complications
12.7 Results in the Literature
12.8 Conclusion and Clinical Relevance
References
13: Endoscopic Facet Denervation
13.1 Indication
13.2 Preinterventional Diagnostics
13.3 Necessary Instruments
13.3.1 Costs
13.4 Pre-Intervention Education
13.5 Implementation of the Intervention
13.6 Possible Complications
13.7 Results in the Literature
13.8 Conclusion and Clinical Relevance
References
14: Epidural Neurolysis, Minimally Invasive Catheter Technique According to Racz
14.1 Indication
14.2 Preinterventional Dignostics
14.3 Necessary Instruments
14.4 Pre-Intervention Education
14.5 Implementation of the Intervention
14.6 Possible Complications
14.7 Results in the Literature
14.8 Conclusion and Clinical Relevance
References
15: Minimally Invasive Therapy of Metastases to the Spine Using the Cavity Coblation Method
15.1 Introduction and Indication
15.2 Preinterventional Diagnostics
15.3 Necessary Instruments
15.4 Pre-intervention Education
15.5 Implementation of the Intervention
15.5.1 Surgical Technique of Cavity Coblation
15.5.2 Postoperative
15.6 Possible Complications
15.7 Results in the Literature
15.7.1 Own Clinical Results
15.7.2 Problems and Specific Features of the Method
15.8 Reimbursement of Costs
15.8.1 Coding Peculiarities in the DRG for Intravertebral Radiofrequency Ablation and for Cavity Coblation
15.8.2 Special Features of the Coding of Diagnoses
15.9 Conclusion and Clinical Relevance
References
16: Lumbar Nucleoplasty
16.1 Indication
16.2 Technology
16.3 Preinterventional Diagnostics
16.4 Necessary Instruments
16.5 Pre-Intervention Education
16.6 Implementation of the Intervention
16.7 Possible Complications
16.8 Results in the Literature
16.9 Reimbursement of Costs
References
17: Cervical Nucleoplasty
17.1 Indication
17.2 Disc Decompression (Nucleoplasty): What Is it?
17.3 Preoperative Diagnostics
17.4 Reconnaissance
17.5 Surgical Technique
17.5.1 Intradiscal Section
17.5.2 Postoperative
17.6 Results
References
18: Endoscopic Decompression of the Lumbar and Cervical Spine
18.1 Indication
18.1.1 Lumbar Spine
18.1.2 Cervical Spine
18.1.3 Contraindications
18.2 Preinterventional Diagnostics
18.3 Necessary Instruments
18.4 Pre-Intervention Education
18.5 Implementation of the Intervention
18.5.1 Lumbar Spine
Interlaminar Access (Ruetten 2005; Ruetten et al. 2006, 2007b, 2008b)
18.5.2 Cervical Spine
Dorsal Approach (Ruetten et al. 2007b, 2008b)
Ventral Approach (Ruetten et al. 2009b)
18.6 Possible Complications
18.7 Results in the Literature
18.7.1 Lumbar Spine
Indication Primary Herniated Disc
18.7.2 Cervical Spine
18.8 Conclusion and Clinical Relevance
18.8.1 Other Fields of Application
References
19: Microsurgical Disc Surgery
19.1 Indication
19.2 Preinterventional Diagnostics
19.3 Necessary Instruments
19.3.1 Costs
19.4 Pre-Intervention Education
19.5 Implementation of the Intervention
19.6 Possible Complications
19.7 Results in the Literature
19.8 Conclusion and Clinical Relevance
References
20: Minimally Invasive Spondylodesis Via Percutaneous Approach with Tubular Retractors
20.1 Indication
20.2 Preinterventional Diagnostics
20.3 Necessary Instruments
20.4 Pre-Intervention Education
20.5 Implementation of the Intervention
20.6 Possible Complications
20.7 Results in the Literature
20.8 Conclusion and Clinical Relevance
References
21: Minimally Invasive Microsurgical Lumbar Disc Surgery with Tubular Retractors
21.1 Indication
21.2 Pre-Interventional Diagnostics
21.3 Necessary Instruments
21.4 Pre-Intervention Education
21.5 Implementation of the Intervention
21.6 Possible Complications
21.7 Results in the Literature
21.8 Conclusion and Clinical Relevance
References
22: OLIF Technique (Oblique Lumbar Interbody Fusion)
22.1 Indication
22.2 Preinterventional Diagnostics
22.3 Necessary Instruments
22.4 Pre-Intervention Education
22.5 Implementation of the Intervention
22.6 Possible Complications
22.7 Results in the Literature
22.8 Reimbursement of Costs
22.9 Conclusion and Clinical Relevance
References
23: Lumbar Epiduroscopy
23.1 Introduction
23.1.1 Definition
23.2 Indications
23.2.1 Diagnostic Indications
23.2.2 Therapeutic Indications
23.2.3 Indications According to WISE
23.2.4 Contraindications
23.3 History of Epiduroscopy
23.4 Anatomical Notes
23.4.1 Spinal Cord Spaces
23.5 Pathophysiology, Pathological Findings and Algesiological Relevance
23.5.1 Pathophysiological Observations
23.5.2 Pathological Findings
23.6 Preinterventional Diagnostics
23.7 Necessary Instruments
23.8 Preintervention Education
23.9 Implementation of the Intervention
23.9.1 General Preparations
23.9.2 Positioning of the Patient and Puncture of the Sacral Hiatus
23.9.3 Epidurography
23.9.4 Flushing
23.9.5 Epiduroscopy
23.9.6 Conclusion of Investigation
23.10 Possible Complications
23.11 Results in the Literature
23.12 Reimbursement of Costs
23.13 Conclusion and Clinical Relevance
References
24: Dorsal Root Ganglion Stimulation
24.1 Introduction
24.2 Indications
24.3 Preinterventional Diagnostics
24.4 Necessary Instruments
24.5 Preintervention Education
24.6 Implementation of the Intervention
24.6.1 Positioning of the Patient
24.6.2 C-Arm Positioning and Display of Anatomical Landmarks
24.6.3 Determining the Puncture Route
24.6.4 Sterile Draping of the Patient
24.6.5 Needle Entry Point and Epidural Approach
24.6.6 Inserting the Introducer Sheath
24.6.7 Placement of Support Loops in the Epidural Space
24.6.8 Testing the Probe Position by Stimulation
24.6.9 Removal of the Delivery System, Tunnelling and Evacuation
24.7 Possible Complications
24.8 Results in the Literature
24.9 Reimbursement of Costs
24.10 Conclusion and Clinical Relevance
References
25: Cervical Disc Prosthesis
25.1 Indication
25.2 Preinterventional Diagnostics
25.3 Operational Requirements
25.4 Implementation of the Intervention
25.5 Possible Complications
25.6 Results in the Literature
25.6.1 Connecting Segment Disease
25.7 Reimbursement of Costs
25.8 Conclusion and Clinical Relevance
References
26: Vertebro and Kyphoplasty
26.1 Indication
26.2 Preinterventional Diagnostics
26.3 Pre-Intervention Education
26.4 Percutaneous Vertebroplasty (PVP)
26.4.1 Surgical Technique
26.4.2 Biomechanics and Biology
26.4.3 Clinical Results
26.5 Percutaneous Kyphoplasty (PKP)
26.5.1 Necessary Instruments
26.5.2 Patient Positioning
26.5.3 Setting up, Adjusting and Setting the C-Arms
26.5.4 Implementation of the Intervention
26.5.5 Postoperative Mobilization
26.5.6 Clinical Results
26.6 Literature Based on Randomised Controlled Trials
26.6.1 Vertebroplasty Versus Kyphoplasty
26.7 Possible Complications
26.7.1 Cement Leakage
26.7.2 Connection Fractures
26.7.3 Cost-Effectiveness of Cement Augmentation
References
Further Reading
27: Balloon, Radiofrequency, Vertebro and Cement Sacroplasty for the Treatment of Non-Displaced Insufficiency Fractures
27.1 Indication
27.2 Preinterventional Diagnostics
27.3 Costs and Possible Reimbursement
27.4 Preinterventional Education
27.5 Implementation of the Intervention
27.6 Possible Complications
27.7 Results in the Literature
27.8 Conclusion and Clinical Relevance
References
28: Transiliac Internal Fixator
28.1 Indication
28.2 Preinterventional Diagnostics
28.2.1 Diagnostic Algorithm
28.3 Necessary Instruments
28.3.1 Costs
28.4 Pre-intervention Education
28.4.1 Therapeutic Algorithm
28.4.2 Operations Reconnaissance
28.5 Implementation of the Intervention
28.6 Possible Complications
28.7 Results in the Literature
28.8 Reimbursement of Costs
28.9 Conclusion and Clinical Relevance
References
29: Treatment Options for Sacral Insufficiency Fractures
29.1 History and Epidemiology
29.2 Anatomy and Development
29.3 Biomechanics of the Fracture
29.4 Symptoms
29.5 Diagnostics
29.6 Therapy Options
29.6.1 Conservative
29.6.2 Operational
Sacroplasty/Balloon
Transiliosacral Screw Connection
Transsacral Positioning Rod
Ilioiliac Internal Fixator with Transiliosacral Screw Fixation
Lumbopelvic Stabilization
References
