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Ashok Jadon
Ashok Jadon

interventional procedures

Health & Medicine
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Disclaimer ,[object Object],[object Object],[object Object]
Interventional Pain Management; Way forward to manage chronic pain Dr Ashok Jadon, MD DNB Aesculap Academy IPM Fellowship Sr Consultant Anaesthesia
Objectives ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],What it is ?
Non-opioids Weak opioids +/- non-opioids Strong opioids Recovery Operation Treatment of Low Back Pain World of Misery Non-pharmacological methods
Non-opioids Weak opioids +/- non-opioids Strong opioids Recovery Operation Treatment of Pain IPM Non-pharmacological methods It fills the gap between pharmacologic management of pain & more invasive operative procedure.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],IPM IPM are group of procedures with different mechanism of actions
Scope/ indications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Structures responsible for LBP
Major Causes of Low Back Pain ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www. pain india.net
Low Back Pain: Red Flags ,[object Object],[object Object],[object Object],[object Object],[object Object]
Facet Joint Interventions ,[object Object],[object Object],[object Object],[object Object],[object Object]
Facet Joint Interventions Lumbar “ Scottie Dog” View
C-arm should be rotated such a way so that facet joint is opened up maximally & end plate of two adjacent vertebrae are in line. Disc space between L4-L5 disc Facet joint Inferior end plate of L4 Vertebra Superior end plate of L5 Vertebra
Facet Joint Interventions Lumbar - RF L5 L4 S1
Radiofrequency Ablation (RF)
LBP ; Disc (Disc Cause LBP 25% to 45%)
Disc procedures ,[object Object],[object Object],[object Object],[object Object],[object Object],www. pain india.net
Epidural Approaches ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Midline Interlaminar L5-S1
Transforaminal Approach
 
Transforaminal Approach
Ozone Nucleolysis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Intradiscal Procedures ,[object Object],[object Object],[object Object],[object Object]
I-DET
Percutaneous Disc Decompression/Discectomy www. pain india.net 17G needle introduced, motorized probe is introduced It breaks the nucleus pulposus into fine particles and sucks it out.
Vertebroplasty
POST LAMINECTOMY SYNDROME ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
POST LAMINECTOMY SYNDROME ,[object Object],[object Object],[object Object]
Epidural Adhesinolysis Normal Filling defect in FBSS www. pain india.net
POST LAMINECTOMY SYNDROME ,[object Object]
POST LAMINECTOMY SYNDROME ,[object Object],[object Object],[object Object],[object Object],Spinal cord stimulator Intrathecal pump
Evidence based practices Outcome studies ,[object Object],[object Object],[object Object],www. pain india.net
 
 
 
 
 
 
 
 
 
 
 
Results & Gapes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Thanks Thank you

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Editor's Notes

  1. What are the structures and their pathology responsible for low back pain