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Thoracic Nerve Root and Facet Injections: Computed Tomography 

Thoracic Nerve Root and Facet Injections: Computed Tomography
Chapter:
Thoracic Nerve Root and Facet Injections: Computed Tomography
Source:
Multimodality Imaging Guidance in Interventional Pain Management
Author(s):

Amaresh Vydyanathan

, Allan L. Brook

, Boleslav Kosharskyy

, and Samer N. Narouze

DOI:
10.1093/med/9780199908004.003.0014

Thoracic back pain patients present with associated radiculopathy, degenerative disc disease, spondylosis, stenosis, scoliosis, rib fractures, tumors, or after undergoing thoracic surgery. Thoracic transforaminal or selective nerve root blocks (SNRBs) may be both therapeutic and diagnostic. Therapeutic injections may include either local anesthetics for pain relief or corticosteroids for anti-inflammatory effects. The two types of pain amenable to therapeutic SNRBs include pain caused by irritation or direct pressure on a spinal nerve and pain originating from anatomic structures that are innervated by the sinuvertebral nerve. Although these blocks are traditionally performed under fluoroscopic guidance, computed tomography (CT) and CT fluoroscopy have been increasingly used to direct needle placement and have been advocated by experts due to superior visualization of the needle tip and the ability to clearly define spinal anatomy and adjacent soft-tissues.

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