Virtual Didactic - Choosing the Right Patient & Procedure for the Spine presented by Aaron Yang, MD-Choosing the Right Patient & Procedure for the Spine Led by Aaron Yang, MD

Video Transcription

Video Summary

Dr. Yang gave a lecture on various pain management procedures and techniques. He discussed epidural steroid injections for radicular pain and the importance of advanced imaging in guiding the procedure. He also explained the different types of epidural injections, such as transforaminal, interlaminar, and caudal, and their respective targets. Dr. Yang mentioned the use of corticosteroids in the epidural space and their role in inhibiting the inflammatory cascade. He also emphasized the importance of better targeting for better outcomes in epidural procedures.<br /><br />Moving on, Dr. Yang discussed facet-mediated pain and the use of medial branch blocks for diagnosis. He explained the innervation of facet joints and the differences between intraarticular and medial branch injections. He also discussed radiofrequency ablation as a therapeutic option for facet pain. Dr. Yang clarified that radiofrequency ablation targets the posterior portion of the facet joint complex and not the articular portion.<br /><br />Regarding the sacroiliac joint (SI) complex, Dr. Yang highlighted the limitations of history, physical exam, and imaging in diagnosing SI joint pain. He mentioned the importance of differentiating between intraarticular and extraarticular sources of pain in the SI joint. Dr. Yang explained the use of sacroiliac branch blocks for diagnosis and the variability of success rates in radiofrequency ablation of the SI joint.<br /><br />In conclusion, Dr. Yang emphasized the need for a solid foundation in pain management procedures and the importance of asking questions and understanding the rationale behind choices of medication and techniques. He also discussed the limitations of certain procedures and the ongoing debates in the field.

Keywords

pain management procedures

epidural steroid injections

radicular pain

advanced imaging

corticosteroids

facet-mediated pain

medial branch blocks

radiofrequency ablation

sacroiliac joint (SI) complex

questions in pain management