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Guided (and anatomically landmarked) spinal injections 

Guided (and anatomically landmarked) spinal injections
Guided (and anatomically landmarked) spinal injections

John Tanner

and Michael Hutson

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date: 12 June 2021

Anyone considering performing spinal injections needs proper training to achieve a defined level of competence. This is usually available within a specialty or may be provided by a multidisciplinary organization (such as the British Institute of Musculoskeletal Medicine in the UK). Spinal injections usually involve the use of local anaesthetics within or close to the epidural space, and so entail potential risks. The operator therefore needs to have available a skilled nurse or assistant; intravenous fluids; oxygen; emergency drugs including adrenaline (epinephrine), hydrocortisone succinate, diazepam, and others; as well as resuscitation equipment. The operator should also regularly update their knowledge through advanced life support courses (run by the Resuscitation Council in the UK). The descriptions of techniques outlined in this chapter (for both spinal injections under fluoroscopic control and spinal injections using anatomical landmarks), although detailed, are no substitute for proper training under supervision.

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