Injections may be considered for pain relief after nonsurgical methods are tried for several weeks and before surgery is considered. While performing injection treatments, fluoroscopic x-ray guidance is usually used for correct needle placement.
Fluoroscopic guidance and contrast dye help improve diagnostic accuracy and decreases procedural risks. Injections may also be used diagnostically as a selective nerve block to confirm the nerve root as the cause of the leg pain and may be helpful as a diagnostic aid prior to surgery. Surgery is considered when a structural condition that is known to be responsive to surgical treatment is present.
See Microdiscectomy Microdecompression Spine Surgery. Which big spine muscle was causing his problem? It goes from the pelvis to the back of the ribs. This is why he felt new pain developing from his back to the back part of his ribs. This was to be expected due to the multifidus atrophy that was clearly seen on his MRI, but not read out by the reading radiologist.
This is why his doctors ordered a completely unnecessary thoracic MRI. What can we do differently? First, we no longer use high-dose steroids for epidurals. Why do we inject that epidural rather than high-dose steroids? The steroids damage local tissue, while platelet growth factors can help to repair tissue and they can also manage inflammation for longer.
See my video below:. While his prior doctors did a test like that called a discogram, they failed to inject anything that could help repair the disc. To see what that procedure looks like, see my video below:. The upshot? That led his physicians on a wild goose chase because they never listened to him long enough for him to tell them what was wrong. They also lacked the experience to see how his problem was developing and how to treat it with regenerative medicine techniques.
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Asian Spine. Download references. Collection, analysis, and interpretation of data and in writing the manuscript was funded in part by the Guizhou Provincial Science and Technology Department Joint Fund.
The contents of this article are solely the responsibility of the authors and do not reflect the views of the Guizhou Provincial Science and Technology Department. You can also search for this author in PubMed Google Scholar. WJ K was responsible for the design and writing of the manuscript; TY C and S Y were responsible for the collection of data and images; FJ W was responsible for the statistical analysis of the data; YM S was responsible for the design and the revision of the article.
All authors read and approved the manuscript. Correspondence to Yueming Song. Written consent was obtained from all participants. We have obtained written consent to publish and report individual patient data from the participants.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Reprints and Permissions. Kong, W. Treatment of L5 - S1 intervertebral disc herniation with posterior percutaneous full-endoscopic discectomy by grafting tubes at various positions via an interlaminar approach.
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