Skip to main content
SpringerLink
Log in

Advanced Spinal Mapping: An Interventional Continuum for Axial, Radicular, and Dorsal Root Ganglion–Related Pain

  • Chapter
  • First Online:
Advanced Procedures for Pain Management

Abstract

The anatomy of the spine can undergo numerous changes that result in pain. Various forms of chronic pain, including pain of the neck, back, or extremities, may indicate one or more spinal pathologies. Differing treatments may be used depending on the pain generator, including radiofrequency neurotomy, corticosteroid injection, decompression, and neurostimulation. Utilizing an appropriate treatment may be challenging, given frequently comorbid spinal pathologies and potentially overlapping symptoms. Spinal mapping enables the identification and treatment of the appropriate pain generator. Spinal mapping and subsequent treatments can be used for a number of varying indications:

  • Facet arthropathy

  • Posterior disc herniation or extrusion

  • Anterior disc herniation or extrusion

  • Central canal stenosis

  • Lateral canal stenosis

  • Neuroforaminal stenosis

  • Chemical disruption of the disc

  • Intradiscal pressure

  • Annular disc tear

  • Dorsal root ganglion (DRG) mapping to optimize DRG stimulation

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

Access this chapter

Log in via an institution

Institutional subscriptions

Similar content being viewed by others

References

  1. Denis F. The three column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine. 1983;8:817–31.

    Article  CAS  PubMed  Google Scholar 

  2. Markman JD, Philip A. Interventional approaches to pain management. Anesthesiol Clin. 2007;25:883–98.

    Article  CAS  PubMed  Google Scholar 

  3. Alò K, Abramova M, Redko V, Williams J, McKee M, Noto D, et al. Technical update in spinal mapping, epidural disc and neural decompression, and neurostimulation: an interventional continuum for axial and radicular pain. Minim Invasive Surg Pain. 2013;1:54–62.

    Google Scholar 

  4. Dreyfuss P, Bogduk N. Lumbar medial branch neurotomy. In: Schmidt RF, Willis WD, editors. Encyclopedia of pain. New York: Springer; 2007. p. 1076–9.

    Chapter  Google Scholar 

  5. Mikeladze G, Espinal R, Finnegan R, Routon J, Martin D. Pulsed radiofrequency application in treatment of chronic zygapophyseal join pain. Spine J. 2003;3:360–2.

    Article  PubMed  Google Scholar 

  6. Alò K, Abramova M, Cantu F, DeAndres J, Lierz P, Manchiaro P, et al. Technical update: axial and radicular pain. Recent advances in spinal pain mapping, epidural decompression and neurostimulation. Region Anesth Pain Med. 2011;36:45–9.

    Google Scholar 

  7. Manchikanti L, Boswell MV, Rivera JJ, Pampati VS, Damron KS, McManus CD, et al. A randomized, controlled trial of spinal endoscopic adhesiolysis in chronic refractory low back and lower extremity pain. BMC Anesthesiol. 2005;5:10.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Heavner J, Chokhavatia S, Kizelshteyn G. Percutaneous evaluation of the epidural and subarachnoid space with a flexible fiberscope. Reg Anesth. 1991;15(Suppl 1):85.

    Google Scholar 

  9. Raffaeli W, Caminiti A. L’endoscopia dello spazio epidurale – periduroscopia. Pathos. 2007;14(Suppl 1):61–5.

    Google Scholar 

  10. Richter E, Abramova M, Mussell J. Current trends in minimally invasive spinal surgery. J Neurosurg Rev. 2011;1(Suppl 1):1–13.

    Google Scholar 

  11. Richter EO, Abramova MV, Cantu F, DeAndres J, Lierz P, Manchiaro PL, et al. Anterior epiduroscopic neural decompression: eight-center experience in 154 patients. Eur J Pain Suppl. 2012;5:401–7.

    Article  Google Scholar 

Suggested Reading

  • Alò K, Abramova M, Richter E. Percutaneous peripheral nerve stimulation. Prog Neurol Surg. 2011;24:41–57.

    Article  PubMed  Google Scholar 

  • Alò K, Abramova M, Redko V, Williams J, McKee M, Noto D, et al. Technical update in spinal mapping, epidural disc and neural decompression, and neurostimulation: an interventional continuum for axial and radicular pain. Minim Invasive Surg Pain. 2013;1:54–62.

    Google Scholar 

  • Raffaeli W, Righetti D, Andruccioli J, Sarti D. Epiduroscopy and radiofrequency technique: the Raffaeli-Righetti technique. Pain Clin. 2007;19:1–7.

    Article  Google Scholar 

  • Saberski LR, Kitahata LM. Direct visualization of the lumbosacral epidural space through the sacral hiatus. Anesth Analg. 1995;80:839–40.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Arizona Pain/Pain Doctor, Glendale, AZ, USA

    Jonathan D. Carlson

  2. The Methodist Hospital Research Institute, Texas Medical Center, Houston, TX, USA

    Kenneth M. Aló

Authors
  1. Jonathan D. Carlson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kenneth M. Aló
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jonathan D. Carlson .

Editor information

Editors and Affiliations

  1. Lenox Hill Hospital, New York, New York, USA

    Sudhir Diwan

  2. The Center for Pain Relief, Charleston, West Virginia, USA

    Timothy R Deer

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Carlson, J.D., Aló, K.M. (2018). Advanced Spinal Mapping: An Interventional Continuum for Axial, Radicular, and Dorsal Root Ganglion–Related Pain. In: Diwan, S., Deer, T. (eds) Advanced Procedures for Pain Management. Springer, Cham. https://doi.org/10.1007/978-3-319-68841-1_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-68841-1_1

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-68839-8

  • Online ISBN: 978-3-319-68841-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation