This volume provides up-to-date information on interventional pain management, and contains step-by-step explanations to make techniques accessible. The text covers: mechanisms of pain and their clinical implications; spinal drugs delivery system; and advanced managemment techniques as well as future techniques. Each chapter contains practical suggestions for improving the success rate of interventional pain management techniques and avoiding pitfalls.
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Book Description
Editorial Reviews
From The New England Journal of Medicine
Intervention for pain is an extremely important subject because of the many patients with chronic pain and the frequency with which interventions for pain are performed. New procedures are regularly introduced, often without sufficient documentation of their value, and traditional procedures continue to be used without sufficient documentation of their lasting value. This book, which is a compilation of opinions and descriptions of techniques from a large group of experts in pain management, is an extremely important addition to the field.
The book begins with a theory that is meant to explain pain as a human process and that is supplemented by an up-to-date, detailed analysis of the anatomy, physiology, and pharmacology of the pain system. Since the spine is the most common origin of pain, it is gratifying to see an excellent review of the functional anatomy of the spine. More interventions are directed to the spine than anywhere else in the body, so understanding spinal abnormalities and how they can produce pain is of great importance to clinicians. The use of diagnostic blockade in spinal disease is also well covered. The development of long-acting narcotic compounds has redirected attention to the pharmacologic management of pain. The chapter on this topic is brief but thorough and is followed by a general assessment of how the whole patient must be cared for if interventions are to be useful. Anyone in the field of pain management can read the first part of this book to advantage, and anyone who is treating patients for pain should do so.
The second part of the book relates to the evaluation of patients who have pain. It is a good summary but is not sufficiently detailed. The chapter on diskography is useful, and there is a chapter on spinal endoscopy. However, these chapters suffer from the same problem that weakens general articles in the literature: the techniques are described in detail, but their diagnostic value is not substantiated. The predictive or diagnostic value of diskography and endoscopy remains to be proved, and both procedures are associated with serious complications and add substantially to medical costs. The same can be said for differential nerve blocks in the evaluation of chronic pain. The authors of the chapter on this topic make a classic error, which is to equate the response to local injection of placebo with a psychogenic mechanism. This assumption is simply not valid. A chapter on placebos would have improved the book substantially.
The third part of the book, a how-to manual, describes a broad spectrum of interventional procedures for the management of chronic and acute pain. The chapters on the pharmacology of local anesthetics and neurolytic agents should be required reading for anyone using these interventions. The remaining chapters in this part of the book are superb descriptions of procedures. Some of these chapters outline straightforward interventions, well established in practice, with much documentation; others describe techniques for which outcomes have not been clearly established.
The principal shortcoming of the book is the lack of documentation of the outcomes for many of the procedures described. For example, intradiskal electrothermal annuloplasty is described in great detail, but only single paragraphs deal with the indications and outcomes of the procedure. The failure to document outcomes affects the entire field of pain management, particularly with respect to many percutaneous interventions. As a manual of procedures, this is a superb book, with detailed and well-illustrated descriptions of every form of nerve block and percutaneous intervention. The lack of a discussion of outcomes does not detract from its usefulness. However, the authors are obviously ``believers,'' and readers unfamiliar with the techniques do not learn about the reservations that many hold about some procedures.
The chapters on implantable devices for the stimulation of the nervous system are a valuable addition. The extensive documentation in the field of neurostimulation provides an excellent example of how outcomes research should precede and follow the introduction of any new technique.
This up-to-date, detailed, and authoritative book provides a superb reference for the techniques of various blocks and percutaneous interventions used in pain management. Deficiencies in the discussions of approaches to diagnosis, indications for procedures, and outcomes of procedures do not detract from its great practical value.
Don M. Long, M.D., Ph.D.
Copyright © 2001 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS. (From the New England Journal of Medicine, August 2, 2001)
--This text refers to an out of print or unavailable edition of this title.
Review
"This is a very valuable addition to the few well-written books relating to interventional pain management. It is an excellent resource for the trainee as well as for practicing interventional pain physicians."-Anesthesia & Analgesia, review of the previous edition.
--This text refers to an out of print or unavailable edition of this title.
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Most Helpful Customer Reviews
13 of 14 people found the following review helpful:
2.0 out of 5 stars
False Advertising,
By Ligament (Chicago) - See all my reviews
This review is from: Interventional Pain Management: Image-Guided Procedures with DVD, 2e (Hardcover)
This review pertains to the 2nd edition 2008 release of this title.
Per the back cover of the book: "See exactly how to proceed via a DVD of video clips, demonstrating proper patient positioning and difficult procedures..." This is one of the major reasons I purchased this book, and likely one of the major reasons other people are considering this book. However, the DVD only covers THREE different procedures! They are: 1. Hypogastric Plexus Block 2. Lumbar sympathetic block 3. Splanchnic nerve block This is all that is on the DVD!!! Out of the dozens if not hundreds of procedures in this textbook, why only videos of these three? They are by no means the most difficult pain procedures to master, nor are they very commonly employed in *most* pain practices, with the exception of the lumbar sympathetic block for CRPS/RSD. Furthermore, these video clips were not made for this book, they are recycled videos from the University of Texas Pain Department that were filmed long ago, and sold under by the World Institute of Pain on its website on a DVD called "Instructional DVD Video #1 for interventional pain treatment techniques." So, I already had the exact same videos which I had purchased from the WIP previously! What a disappointment! Secondly, these videos have a commercial agenda in employing only the Epimed curved blunt tip needles, which are an invention of Dr. Racz and manufactured by Epimed, whose President is Dr. Racz' son! Other than 1. Only three techniques covered 2. Commercial bias I think the video is quite good. But one would think there should be dozens of techniques on this DVD not just three!
12 of 14 people found the following review helpful:
4.0 out of 5 stars
Good Book!,
This review is from: Interventional Pain Management, 2e (Hardcover)
Good Book!
This is no doubt the most comprehensvie interventional pain management book that has been published so far. The value of having it on your bookshelf for quick reference during practice and for continued self improvement as an interventionist is of great significance. However, it is far from perfection. Part I, "Anantomy and Physiology of Pain: Clinical Correlates" serves as the basic review of Anantomy and Pharmacology of pain processing system. The best chapter in this part is the "Functional Anatomy of the Spine" which contains detailed description and illustration of spine innervation from Atlantooccipital joint to lumbosacral facet, intervetebral discs, spinal nerves, etc. A concise review on techniques on performing selective diagnostic injections of the spinal axis at the end of this chapter including discography, nerve root sleeve approach and facet joint makes this chapter much more clinically relavant. Part III, "Neural Blockade and Neurolytic Blocks", describes and demonstrates A to Z interventional techniques for blocking both neuroaxial and peripheral nerves. The chapters on radiofrequency techniques are very well written, thorough and easy to follow. However, it would be much better if authors included procedure codes for such procedrues as Rhizotomy of SI joint, RF lesioning of ramus communicans nerve, Ganglionotomy of cervical, thoracic and lumbar levels, RF lesioning of lumbar disc of which the procedural codes are no where to be found. I personally have been struggling to find such codes for the above techniques in my practice. The chapters on performing sympathetic block at various levels are also clearly illustrated and easy to follow, which serve well as the guide for performing these blocks in comparion to other interventional books which lack such content. Nervertheless, Part III also has many weaknesses. In fact, some of the techniques introdueced are rather old and obsolete especially when judging from the progress achieved in interventional pain management by 2001, but unfortunately without being incorporated into this section. E.g, most well trained interventional pain specialists will agree that fluoroscopy serves as "eyes" for the intervetionist, however, some of the chapters discussing neuroaxial intervential techniques do not even have any fluoroscopic image, such as the chapter on lumbar epidural block as well as the one on Sacroiliac joint injection. The worst chapter of all is the "Sacroiliac Joint Injection and Low Back Pain". First of all as mentioned above, it does not have any fluroscopic picture. Secondly, the patient was placed "supine position" instead of prone, yet, the "PSIS" was identified? How can someone identify PSIS from front? Let's just assume this is a "typo" error. Even so, no matter how many times I read through the procedural description, I still could not figure out how this was done. For someone like me, who is Board Certified in American Board of Physical Medicine and Rehabilitation, American Board of Pain Medicine, an interventional pain management fellowship trained spine interventionist, who simply could not make sense of such a simple procedre from its description. I wonder whether the author who wrote this chapter really knew how to perform SI joint injection. Maybe it means that this portion should be re-written. This is actually the main reason that I give this book 4 stars rating despite there are many other chapters that are very well written and useful for interventional pain practice. Another shortcoming is that some of the commonly performed procedures such selective nerve root block or transforaminal epidural were nerver even mentioned in Part III, but I think, should have been done so, although in the Chapeter of "Functional Anatomy of the Spine" of part I, selective nerve root sleeve appraoch was briefly introduced, it should also be here in Part III as this is the neural blockade section. Lastly, many of the interventionists consider "Selective Nerve Root Block"(SNRB) and/or Transforaminal Epidural Injection (TFEI) "bread and butter" of spine intervention, yet, this "most comprehensive interventional pain bible" with close to 800 pages does not even have them in its word index, which undoubtedly impacts negatively on its authority. Part IV & Part V, "Neuroaugmentation" & "Spinal Administration of Opioids & Other Analgesic Compounds" are the best work of this book. They are the best resoures available for spinal cord stimulation and intrathecal drug delivery pump. The authors did outstanding work in writing up these chpaters and introducing to readers step by step the mechanisms, patient selection, implantation techniques and complications. The chapters on intrathecal drug delivery pump has helped my practice tremendously. However, the only shortingcoming is that it does not have chapter addressing Intrathecal Baclofen pump for Spasticity and Spasticity related pain syndromes. There are quite a number of patients with spasticity disorders due to brain injury, spinal cord injury, multiple sclerosis, etc, requiring implanted intrathecal baclofen pump. However, there is severe lack of resources in guiding the long term management of such patients, ie, maximal drug concentration, maximal daily drug dosage, drug holidays, etc. The purpose of this review is also to give the editors some of the feedback from interventional pain physicians like me so as to extract more "nutrients" from its contributors in the future and to make the Third Edition a greater success, in addition to share my experience from learning this book and utilizing what I have learned in the practice of interventional pain managent.
2 of 2 people found the following review helpful:
5.0 out of 5 stars
good book for fellows,
Amazon Verified Purchase(What's this?)
This review is from: Interventional Pain Management: Image-Guided Procedures with DVD, 2e (Hardcover)
good book for fellows, details about most procedures, nice diagrams and pictures. I recommend it for all fellows in pain meds.
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