Skip to main content
SpringerLink
Log in
Book cover

Essentials of Interventional Techniques in Managing Chronic Pain pp 63–88Cite as

Anatomy of the Spine for the Interventionalist

  • Chapter
  • First Online:

Abstract

Interventional pain physicians performing spinal injections must have a detailed understanding of the spinal anatomy in order to perform safe and effective spinal procedures. An interventionalist must learn the important aspects of the spinal anatomy as it relates to interventional pain management. Interventional pain management includes physicians from various specialties with physical medicine and rehabilitation physicians and excellent understanding of anatomy; however, they may have little experience in regional anesthesia or fluoroscopy. In contrast, anesthesiologists often begin interventional pain management with excellent tactile skills from years of performing blind injections for regional anesthesia, but may lack expertise in the understanding of fluoroscopic anatomy. Radiologists may be experts in the use of fluoroscopy and understanding of the anatomy; however, radiologists may be lacking tactile techniques of regional anesthesia. Understanding anatomy with anatomical planes, specifically spinal column, fluoroscopic anatomy with bony elements, ligaments of the spine, and discs, and the understanding of multiple compartments of the spine are essential components of interventional pain management.

This is a preview of subscription content, log in via an institution.

References

  1. Schultz DM. Spinal anatomy for the interventionalist. In: Manchikanti L, Singh V, editors. Interventional techniques in chronic spinal pain. Paducah: ASIPP Publishing; 2007. p. 33–56.

    Google Scholar 

  2. Standring S. Gray’s anatomy: the anatomical basis of clinical practice. 39th ed. New York: Churchill-Livingstone; 2005. p. 735.

    Google Scholar 

  3. Bogduk N. Clinical anatomy of the lumbar spine and sacrum. 4th ed. New York: Churchill Livingstone; 2005.

    Google Scholar 

  4. Standring S. Gray’s anatomy: the anatomical basis of clinical practice. 39th ed. New York: Churchill-Livingstone; 2005. p. 756.

    Google Scholar 

  5. Mercer S. The ligaments and annulus fibrosus of human adult cervical intervertebral discs. Spine (Phila Pa 1976). 1999;24:619.

    Article  CAS  Google Scholar 

  6. Tanaka N, Fujimoto Y, An HS, et al. The anatomic relation among the nerve roots, intervertebral foramina, and intervertebral discs of the cervical spine. Spine (Phila Pa 1976). 2000;25:286–91.

    Article  CAS  Google Scholar 

  7. Lord SM, Barnsley L, Bogduk N. Cervical zygapophysial joint pain in whiplash injuries. In: Malanga GA, editor. Cervical extension-flexion whiplash injuries. Philadelphia: Hanley and Belfus; 1998. p. 301–44.

    Google Scholar 

  8. Gray’s anatomy. 13th American ed. p. 696–9.

    Google Scholar 

  9. Schultz D, Manchikanti L, Racz GB. Cervical transforaminal epidural injections. In: Manchikanti L, Singh V, editors. Interventional techniques in chronic spinal pain. Paducah: ASIPP Publishing; 2007. p. 455–78.

    Google Scholar 

  10. Engel A, King W, MacVicar J, Standards Division of the International Spine Intervention Society. The effectiveness and risks of fluoroscopically guided cervical transforaminal injections of steroids: a systematic review with comprehensive analysis of the published data. Pain Med. 2014;15:386–402.

    Article  PubMed  Google Scholar 

  11. Scanlon GC, Moeller-Bertram T, Romanowsky SM, et al. Cervical transforaminal epidural steroid injections. More dangerous than we think? Spine (Phila Pa 1976). 2007;32:1249–56.

    Article  Google Scholar 

  12. Atluri S, Glaser SE, Shah RV, et al. Needle position analysis in cases of paralysis from transforaminal epidurals: consider alternative approaches to traditional techniques. Pain Physician. 2013;16:321–34.

    PubMed  Google Scholar 

  13. Manchikanti L, Candido KD, Singh V, et al. Epidural steroid warning controversy still dogging FDA. Pain Physician. 2014;17:E451–74.

    PubMed  Google Scholar 

  14. Netter FH. Atlas of human anatomy. 4th ed. Philadelphia: Saunders, Elsevier; 2006.

    Google Scholar 

  15. Drake R, Vogl W, Mitchell AWM. Grays anatomy for students. Philadelphia: Elsevier; 2005.

    Google Scholar 

  16. Botwin K. Lumbar interlaminar epidural steroid injections. In: Manchikanti L, Singh V, editors. Interventional techniques in chronic spinal pain. Paducah: ASIPP Publishing; 2007. p. 355–82.

    Google Scholar 

  17. Manchikanti L, Singh V. Caudal epidural injections. In: Manchikanti L, Singh V, editors. Interventional techniques in chronic spinal pain. Paducah: ASIPP Publishing; 2007. p. 331–54.

    Google Scholar 

Download references

Acknowledgments

This book chapter is modified and updated from a previous book chapter, “Spinal Anatomy for the Interventionalist” by David M. Schultz, MD, in Interventional Techniques in Chronic Spinal Pain published by ASIPP Publishing. Permission has been obtained from ASIPP Publishing.

Author information

Authors and Affiliations

  1. Medical Advanced Pain Specialists Medical Pain Clinics, Shorewood, MN, USA

    David M. Schultz

Authors
  1. David M. Schultz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David M. Schultz .

Editor information

Editors and Affiliations

  1. Pain Management Center of Paducah, Paducah, Kentucky

    Laxmaiah Manchikanti

  2. Department of Anesthesia, LSU Health Science Center, New Orleans, Louisiana, USA

    Alan D. Kaye

  3. Mid Atlantic Spine and Pain Physicians, Newark, Delaware

    Frank J.E. Falco

  4. Service Line Chief of Interventional Radiology, Director of Interventional Neuroradiology, Chief of NeuroInterventional Spine Service, Massachusetts General Hospital, Boston, Massachusetts, USA

    Joshua A. Hirsch

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Schultz, D.M. (2018). Anatomy of the Spine for the Interventionalist. In: Manchikanti, L., Kaye, A., Falco, F., Hirsch, J. (eds) Essentials of Interventional Techniques in Managing Chronic Pain. Springer, Cham. https://doi.org/10.1007/978-3-319-60361-2_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-60361-2_7

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-60359-9

  • Online ISBN: 978-3-319-60361-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation