Nội dung

Atlas of Ultrasound-Guided Procedures in Interventional Pain Management Second Edition Samer N. Narouze Editor 123 Atlas of Ultrasound-Guided Procedures in Interventional Pain Management Samer N. Narouze Editor Atlas of Ultrasound-Guided Procedures in Interventional Pain Management Second Edition Editor Samer N. Narouze Professor of Anesthesiology and Pain Medicine Center for Pain Medicine Western Reserve Hospital Cuyahoga Falls, OH, USA ISBN 978-1-4939-7752-9    ISBN 978-1-4939-7754-3 https://doi.org/10.1007/978-1-4939-7754-3 (eBook) Library of Congress Control Number: 2018941488 © Springer Science+Business Media, LLC, part of Springer Nature 2011, 2018 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Printed on acid-free paper This Springer imprint is published by the registered company Springer Science+Business Media, LLC part of Springer Nature. The registered company address is: 233 Spring Street, New York, NY 10013, U.S.A. To my wife, Mira, and my children, John, Michael, and Emma – the true love and joy of my life. Without their continued understanding and support, I could not have completed this book. This book is dedicated to the memory of my father who always had faith in me and to my mother for her ongoing love and guidance. Foreword For much of the past decade, fluoroscopy held sway as the favorite imaging tool of many practitioners performing interventional pain procedures. Quite recently, ultrasound has ­ emerged as a “challenger” to this well-established modality. The growing popularity of ultrasound application in regional anesthesia and pain medicine reflects a shift in contemporary views about imaging for nerve localization and target-specific injections. For regional anesthesia, ultrasound has already made a marked impact by transforming antiquated clinical practice into a modern science. No bedside tool ever before has allowed practitioners to visualize needle advancement in real time and observe local anesthetic spread around nerve structures. For interventional pain procedures, I believe this radiation-free, point-of-care technology will also find its unique role and utility in pain medicine and can complement some of the imaging demands not met by fluoroscopy, computed tomography, and magnetic resonance imaging. And over time, practitioners will discover new benefits of this technology, especially for dynamic assessment of musculoskeletal pain conditions and improving accuracy of needle injection for small nerves, soft tissue, tendons, and joints. Ultrasound application for pain medicine is an evolving subspecialty area. Most conventional pain interventionists skilled in fluoroscopy will find it necessary to undertake some special learning and training to acquire a new set of cognitive and technical skills before they can optimally integrate ultrasound into their clinical practices. Although continuing medical educational events help facilitate the learning process and skill development, they are often limited in breadth, depth, and training duration. This is why the arrival of this comprehensive text, Atlas of Ultrasound-Guided Procedures in Interventional Pain Management, is so timely and welcome. To my knowledge, this is the first illustrative atlas of its kind that addresses the educational void for ultrasound-guided pain interventions. Preparation of this atlas, containing 6 parts and 30 chapters and involving more than 30 authors, is indeed a huge undertaking. The broad range of ultrasound topics selected in this book provides a good, solid educational foundation and curriculum for pain practitioners both in practice and in training. Included is the current state of knowledge relating to the basic principles of ultrasound imaging and knobology, regional anatomy specific to interventional procedures, ultrasound scanning and image interpretation, and the technical considerations for needle insertion and injection. The ultrasound-guided techniques are described step-by-step in an easy-to-follow, “how to do it” manner for both acute and chronic pain interventions. The major topics include somatic and sympathetic neural blockade in the head and neck, limbs, spine, abdomen, and pelvis. Using a large library of black-and-white images and colored illustrative artwork, the authors elegantly impart scientific knowledge through the display of anatomic cadaveric dissections, sonoanatomy correlates, and schematic diagrams showing essential techniques for needle insertion and injection. The information in the last two chapters of this book is especially enlightening and unique and is not commonly found in other standard pain textbooks. One chapter describes how ultrasound can be applied as an extension of physical examination to aid pain physicians in the diagnosis of musculoskeletal pain conditions. With ultrasound as a screening tool, pain physicians now have new opportunities to become vii viii both a diagnostician and an interventionist. The last chapter discussing advanced ultrasound techniques for cervicogenic headache, stimulating lead placement, and cervical disk injection gives readers a glimpse of future exciting applications. This book is a distinguished product carefully prepared by Dr. Samer Narouze, the editor, and his handpicked group of contributors from all over the world. The authors are all recognized opinion leaders in anesthesiology, pain medicine, anatomy, and radiology. I believe this quick reference book containing useful practical information will become a standard resource for any practitioner who seeks to learn ultrasound-guided interventional pain procedures for relief of acute, chronic noncancer, and cancer pain. I am sure the readers will find this atlas comprehensive, inspiring, practical, and easy to follow. Vincent W. S. Chan, Department of Anesthesia, University of Toronto Toronto, ON, Canada Foreword Preface Over the past decade, ultrasonography provided to be a valuable imaging modality in ­interventional pain practice. The interest in ultrasonography in pain medicine (USPM) has been fast growing, as evidenced by the plethora of published papers in peer-reviewed journals as well as presentations at major national and international meetings. This has prompted the creation of a special interest group on USPM within the American Society of Regional Anesthesiology and Pain Medicine, of which I am honored to be the chair. The major advantages of ultrasonography (US) over fluoroscopy include the absence of radiation exposure for both patient and operator, and the real-time visualization of soft tissue structures, such as nerves, muscles, tendons, and vessels. The latter is why US guidance of soft tissue and joint injections brings great precision to the procedure and why ultrasound-guided pain nerve blocks improve its safety. That said, USPM is not without flaws. Its major shortcomings are the limited resolution at deep levels, especially in obese patients, and the artifacts created by bone structures. While the evidence points to the superiority of US over fluoroscopy in peripheral nerves, soft tissue, and joint injections, it also suggests that we should not abandon fluoroscopy in favor of US in spine injections and should instead consider combining both imaging modalities to further enhance the goal of a successful and safer spine injection. When I first started using US in pain blocks in 2005, there was no single text on the subject, and that remains true up until the first edition of this atlas in 2011. Most of my knowledge on the subject was gained from traveling overseas to learn from expert sonographers, radiologists, and anatomists. The rest was worked out by trial and error using dissected cadavers and confirming appropriate needle placement with fluoroscopy or CT scan. When I started teaching courses on USPM, the overwhelmingly enthusiastic response from students persuaded me of the need for a comprehensive and easy-to-follow atlas of US-guided pain blocks. That is how the first edition of this book – the first to cover this exciting new field – was born. Recent research evaluating ultrasonography in interventional pain procedures, the development of new technique and applications, and the establishment of neurosonology necessitates this version of the atlas with many updated and new chapters as well as a new section on diagnostic neurosonologyNot surprisingly, an extensive learning curve is associated with US-guided pain blocks and spine injections. The main objective of this atlas is to enable physicians managing acute and chronic pain syndromes who are beginning to use US-guided pain procedures to shorten their learning curve and to make their learning experience as enjoyable as possible. Among the target groups are pain physicians, anesthesiologists, physiatrists, rheumatologists, neurologists, orthopedists, sports medicine physicians, spine specialists, and interventional radiologists. I was fortunate to gather almost all of the international experts in US-guided pain blocks to contribute to this second edition of the book, each one writing about his or her area of subspecialty expertise, and for this reason, I am very proud of the book. Its central focus is on anatomy and sonoanatomy. The clinical section begins with a chapter devoted to anatomy and sonoanatomy of the spine written by my dear friend, Professor Dr. Moriggl, who is a world-­ class anatomist from Innsbruck, Austria, with special expertise in sonoanatomy. He is the only one who could have written such a chapter. Each clinical chapter follows this format: d­ escription ix x Preface of sonoanatomy accompanied by illustrations; detailed description of how to perform the ­procedure, beginning with the choice and application of the transducer, to how the needle is introduced, and finally, to how to confirm appropriate needle placement. This stepwise description of the technique is enhanced by sonograms both without labels and – to better understand the images – with labels. The book comprises 34 chapters, organized into 7 parts, covering US-guided pain blocks in the acute perioperative and chronic pain clinic settings, US-guided MSK applications, as well as diagnostic neurosonology. Part I reviews the imaging modalities available to perform pain procedures and the basics of ultrasound imaging. Two important clinical chapters cover the essential knobology of the ultrasound machine and how to improve needle visibility under US. Part II is the largest and covers the sonoanatomy of the entire spine and spine injection techniques in the cervical, thoracic, lumbar, and sacral areas. All the different applications are well documented with simple illustrations and labeled sonograms to make it easy to follow the text. Part III focuses on abdominal and pelvic blocks. It covers the now-famous transversus abdominis plane (TAP) block, celiac plexus block, and various pelvic and perineal blocks. Part IV addresses peripheral nerve blocks and catheters in the acute perioperative period as well as peripheral applications in chronic pain medicine. Ultrasound-guided stellate and cervical sympathetic ganglion blocks are presented, as are peripheral nerve blocks commonly performed in chronic pain patients (e.g., intercostals, suprascapular, ilioinguinal, iliohypogastric, and pudendal). There is a new chapter on ultrasound-guided occipital nerve block. Part V discusses the most common joint and bursa injections and MSK applications in pain practice. The chapters are written by world experts in the area of MSK ultrasound.Part VI is a new section on diagnostic neurosonology. This section discusses the new application of ultrasound as a diagnostic tool in the diagnosis of different peripheral nerve entrapment syndromes. There is also a chapter devoted to occipital nerve entrapment.Part VII covers advanced and new applications of ultrasound in neuromodulation and pain medicine and looks ahead to its future. Ultrasound-guided peripheral nerve stimulation, occipital stimulation, and groin stimulation are presented as innovative applications of US in the cervical spine area, namely, atlanto-­ axial joint injection and cervical discography. Given the multitude of vessels and other vital soft tissue structures compacted in a limited area, ultrasonography seems particularly relevant in the cervical area. A couple of notes about the book: the text has been kept to a minimum to allow for a maximal number of instructive illustrations and sonograms, and the procedures described here are based on a review of the techniques described in the literature as well as the authors’ experience. The advancement of ultrasound technology and the range of possible clinical circumstances may give rise to other, more appropriate approaches in USPM. Until then, mastering the current approaches will take preparation, practice, and appropriate mentoring before the physician can comfortably perform the procedures independently. It is my hope that this book will encourage and stimulate all physicians interested in interventional pain management. Akron, OH, USA Samer N. Narouze Acknowledgments In preparing Atlas of Ultrasound-Guided Procedures in Interventional Pain Management, I had the privilege of gathering highly respected international experts in the field of ultrasonography in pain medicine. I thank Dr. Chan, professor of Anesthesiology at the University of Toronto and past president of the American Society of Regional Anesthesiology and Pain Medicine (ASRA), for agreeing to contribute a chapter to this book. I also extend my sincere thanks to the founding members of the ASRA special interest group on ultrasonography in pain medicine, who are also my friends and colleagues, for contributing essential chapters in their areas of expertise: Dr. Eichenberger (Switzerland), Dr. Gofeld (Canada), Dr. Morrigl (Austria), Dr. Peng (Canada), and Dr. Shankar (Wisconsin). My sincere thanks to Dr. Galiano and Dr. Gruber of Austria for contributing two chapters to the book – and for introducing me to ultrasound-guided pain blocks when I visited their clinic in Innsbruck in 2005. I also acknowledge my esteemed colleagues from the University of Toronto for their help and support: Dr. McCartney, Dr. Brull, Dr. Perlas, Dr. Awad, Dr. Bhatia, and Dr. Riazi. I cannot thank enough my friends Dr. Huntoon (Mayo Clinic) and Dr. Karmakar (Hong Kong) for agreeing to contribute essential chapters despite their busy schedules. A special thank you to Dr. Ilfeld (UCSD) and Dr. Mariano (Stanford) for their help with the regional anesthesia section; Dr. Bodor (UCSF), Dr. Hurdle (Mayo Clinic), and Dr. Schaefer (CWRU) for their help with the musculoskeletal (MSK) section; and Dr. Samet (Northwestern University) for contributing the diagnostic neurosonology chapter. I express my sincere thanks to all the Springer editorial staff for their expertise and help in editing this book and making it come to life on time. I am very blessed that these experts agreed to contribute to my book, and I am very grateful to everyone. xi