Breakthrough Treatment and Technology
CT-guided Spinal Injections for Back and Neck Pain
The 64-slice spinal CT scan offers unparalleled precision and patient safety during delicate image-guided spine procedures
Executive Vice-chair, Department of Radiology and Biomedical Imaging
Chief, Section of Neuroradiology
University of California, San Francisco
San Francisco, California
The 64-slice CT scanner enables our neuroradiologists to precisely inject small amounts of medication adjacent to the appropriate nerve, joint space, or spinal canal space that is suspected to cause your back or neck pain. This precision leads to a better response to treatment and more accurate assessment of the location of the pain generator.
64-slice spinal CT scan technology also compliments other diagnostic imaging techniques such as MRI and myelography. Our state of the art 3-D imaging reconstruction procedure provides our neuroradiologists with the best clinically available images for viewing spinal anatomy.
The 64-slice scanner used at the UCSF Precision Spine and Peripheral Nerve Center affords our patients unparalleled injection precision and safety during these delicate image-guided spine procedures.
CT-guided procedures may be particularly helpful for patients who:
- Have a history of spinal surgery with instrumentation (e.g. screws, rods) that obscures or distorts imaging of their spinal anatomy.
- Have significant osteoarthritis or soft tissue abnormalities that may hinder fluoroscopy (real time x-ray) techniques intended to visualize spinal joints, nerves roots, and other spinal structures.
- Have spinal stenosis in which the areas for injection are reduced in size and therefore require precise millimeter accuracy.
Advantages and Risks (Indications/Contraindications)
Although fluoroscopy is commonly used to guide back and neck pain injections, the spinal CT scan offers several advantages:
- Prior to a procedure, a high-resolution cross-sectional diagnostic scan may uncover (not uncommon) other sources of pain generators or disease in adjacent discs or facets that were not recognized on routine scans.
- Permits our expert neuroradiologists to more accurately visualize the pertinent anatomy (bone, nerves, soft tissues, and surgical instrumentation) that are not seen using x-ray-based fluoroscopy.
- Plan a safe and effective procedure.
Real time, low radiation dose CT guidance is used during your procedure to precisely guide the needle injection path and to guide the placement and amount of pain medication to the appropriate nerves with better opportunity for diagnostic and therapeutic success. Using CT, our doctors can visualize structures that do not appear on routine x-ray-based fluoroscopy, such as a subtle fracture, disc herniation, or osteophyte formation (bone spur). These conditions may cause or contribute to your back or neck pain. In many cases, the underlying cause of a patient's back and neck pain is pinpointed (or discovered) during the spinal CT scan procedure. When that occurs, the therapy originally planned may be altered to be more effective in treating the patient's pain problem.
As with any x-ray-based procedure, there are small risks associated with radiation. However, our dedicated neuroradiologists use every available technique to minimize your radiation exposure (dose) while striving to achieve the best outcome possible. The new 64-slice scanner, unlike earlier models, quickly records and processes images. Its enhanced speed allows the neuroradiologist to remain in the procedure room as images process. Then, as needed, the doctor can quickly re-direct the course of the needle path, which can reduce procedure time by as much as 75%. This results in less time in uncomfortable positions, and most importantly, a better, safer procedure for the patient.
How Long Does a Procedure Take?
Typically the procedure for a single nerve injection takes less than 30 minutes. Depending on the number of spinal injection sites, the procedure may take as little as 15 minutes to one to two hours, if multiple sites are involved or more complex treatments are undertaken.
Before Your Procedure through Aftercare
The UCSF Precision Spine and Peripheral Nerve Center's wonderful and caring nurses are with you from the time you arrive, throughout your procedure, and during recovery. We are here to answer your questions and follow up with you by phone or email.
Answers to questions many patients often ask are provided in the UCSF Precision Spine and Peripheral Nerve Center's Pretreatment Patient Guide and Discharge Instructions and Home Care Patient Guide. Of course, we welcome your questions and look forward to providing you with exceptional care before, during and after your procedure.