Skip to main content
Log in

Injektionstechniken an der Halswirbelsäule

Injection techniques in the cervical spine

  • Originalien
  • Published:
Der Schmerz Aims and scope Submit manuscript

Zusammenfassung

Die Injektionstherapie an der Wirbelsäule stellt eine Möglichkeit der konservativen Behandlung von degenerativen Wirbelsäulenerkrankungen dar. Der Einsatz von Injektionsverfahren zur Schmerztherapie sollte dabei nicht unkritisch erfolgen. Die Injektionstherapie sollte bei Wirbelsäulenleiden grundsätzlich im interdisziplinären Kontext durchgeführt werden. Die diagnostische Wertigkeit der Injektionsverfahren variiert sehr stark. Um die größtmögliche Patientensicherheit zu gewährleisten, wird eine Vielzahl von bildgebenden Techniken verwendet. Der folgende Artikel bietet eine Übersicht der gängigen Injektionstechniken an der Halswirbelsäule unter fluoroskopischer Kontrolle.

Abstract

Spinal injections are a treatment option in the conservative management of degenerative spinal disorders. The indications must be critically reviewed for every patient. Treatment with injections for painful spinal disorders should be a part of interdisciplinary treatment regimes. The diagnostic value varies between injection procedures. A large number of imaging techniques are used to achieve a precise and safe needle placement in interventional procedures. The following article presents an overview of common fluoroscopy-guided spinal injection techniques for the cervical spine.

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

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5
Abb. 6
Abb. 7
Abb. 8

Literatur

  1. Henschke N, Kuijpers T, Rubinstein SM et al (2010) Injection therapy and denervation procedures for chronic low-back pain: a systematic review. Eur Spine J 19:1425–1449

    Article  Google Scholar 

  2. Boswell MV, Trescot AM, Datta S et al (2007) Interventional techniques: evidence-based practice guidelines in the management of chronic spinal pain. Pain Physician 10:7–111

    PubMed  Google Scholar 

  3. Krämer J (1996) Orthopädische Schmerztherapie. Dt Ärztebl 93:A1961–A1965

    Google Scholar 

  4. Linhardt O, Madl M, Boluki D et al (2007) Minimal-invasive Injektionstherapie beim Lumbalsyndrom. Orthopäde 36:49–58

    Article  PubMed  CAS  Google Scholar 

  5. Grifka J, Boluki D, Linhardt O et al (2007) Minimal-invasive Therapie bei Zervikalsyndromen. Orthopade 36:59–65

    Article  PubMed  CAS  Google Scholar 

  6. Grifka J, Broll-Zeitvogel E, Anders S (1999) Injektionstherapie bei Lumbalsyndromen. Orthopade 28:922–931

    PubMed  CAS  Google Scholar 

  7. Theodoritis T (2012) Stellenwert der Injektionstherapie bei degenerativen Erkrankungen der Lendenwirbelsäule. Orthopade 41:84–99

    Google Scholar 

  8. Manchikanti L, Pampati V, Boswell MV et al (2010) Analysis of the growth of epidural injections and costs in the medicare population: a comparative evaluation of 1997, 2002, and 2006 data. Pain Physician 13:199–212

    PubMed  Google Scholar 

  9. Gilula LA, Lander P (2003) Management of spinal pain with imaging-guided injections. Radiographics 23:189–190

    PubMed  Google Scholar 

  10. Fritz J, Niemeyer T, Clasen S et al (2007) Management of chronic low back pain: rationales, principles, and targets of imaging-guided spinal injections. Radiographics 27:1751–1771

    Article  PubMed  Google Scholar 

  11. Gopinathan A, Peh WCG (2011) Image-guided facet joint injection. Biomed Imaging Interv J 7:e4

    Google Scholar 

  12. Manchikanti L, Cash KA, Moss TL, Pampati V (2002) Radiation exposure to the physician in interventional pain management. Pain Physician 5:385–393

    PubMed  Google Scholar 

  13. Schmid G, Schmitz A, Borchardt D et al (2006) Effective dose of CT- and fluoroscopy-guided perineural/epidural injections of the lumbar spine: a comparative study. Cardiovasc Intervent Radiol 29:84–91

    Article  PubMed  Google Scholar 

  14. Bernau A, Heeg P (2003) Intraartikuläre Punktionen und Injektionen. Indikation – Infektionsprävention – Technik – Komplikation. Orthopade 32:548–570

    PubMed  CAS  Google Scholar 

  15. DePalma MJ (Hrsg) (2011) iSpine: evidence-based interventional spine care. Demos Medical Publishing, New York

  16. Silbergleit R, Mehta BA, Sanders WP, Talati SJ (2001) Imaging-guided injection techniques with fluoroscopy and CT for spinal pain management. Radio Graphics 21:927–942

    CAS  Google Scholar 

  17. Eckel TS (2004) Facet joint injections. In: Mathis JM (Hrsg) Image guided spine interventions. Springer, New York, S 203–205

  18. Barnsley L, Lord S, Bogduk N (1993) Comparative local anesthetic blocks in the diagnosis of cervical zygapophysial joint pain. Pain 55:99–106

    Article  PubMed  CAS  Google Scholar 

  19. Kulkarni AG, Sabet T, Ashley H, Diwan AD (2006) Technical note: the swimmer’s view for cervical facet joint injections. Eur Spine J 15:1150–1152

    Article  Google Scholar 

  20. Renfrew DL, Moore TE, Kathol MH et al (1991) Correct placement of epidural steroid injections: fluoroscopic guidance and contrast administration. AJNR Am J Neuroradiol 12:1003

    PubMed  CAS  Google Scholar 

  21. Bogduk N (2004) Practice guidelines for spinal diagnostic and treatment procedures: cervical transforaminal injection of corticosteroids. International Spine Intervention Society, Kentfield, S 237–248

  22. Gilula LA, Ma D (2007) A cervical nerve root block approach to improve safety. Am J Radiol 189:563–565

    Google Scholar 

  23. Ma DJ, Gilula LA, Riew KD (2005) Complications of fluoroscopically guided extraforaminal cervical nerve blocks. an analysis of 1036 injections. J Bone Joint Surg Am 87:1025–1030

    Google Scholar 

  24. Windsor RE, Storm S, Sugar R, Nagula D (2003) Cervical transforaminal injection: review of the literature, complications and a suggested technique. Pain Physician 6:457–465

    PubMed  Google Scholar 

  25. Stojanovic M, Vu T, Caneris O (2002) The role of fluoroscopy in cervical epidural steroid injections: an analysis of contrast dispersal patterns. Spine 27:509–514

    Article  PubMed  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor gibt für sich und seine Koautoren an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to J. Artner.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Artner, J., Cakir, B., Reichel, H. et al. Injektionstechniken an der Halswirbelsäule. Schmerz 26, 699–706 (2012). https://doi.org/10.1007/s00482-012-1265-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00482-012-1265-y

Schlüsselwörter

Keywords

Navigation