CT-based Pain Therapy

Method

 

CT pain therapy

CT-based pain therapy


Diagram of puncture route

Diagram of puncture route

CT-based pain therapy is a method of treating chronic pain in the context of alterations to the spine resulting from deterioration.

In this process, pain-killing and anti-inflammatory drugs are systematically injected into the small vertebral joints (Facet Joint Blockade – FAB), or the iliosacral joints (ISJ treatment). The planning and control of the medication via CT allows for great precision as it provides an exact imaging of the puncture channel. Complications are therefore virtually excluded.

The main fields of application for CT-based pain therapy are pain caused by irritation of the nerve roots and the small vertebral joints, whereby the reasons for pain can be varied in nature.

Therapy is not feasible if your coagulation rate is inadequate or abnormally changed, if there is local inflammation, if you are taking steroids due to existing disease and this represents a contra-indication, or if you are over-sensitive to steroids or local anaesthetics. It is also impossible when there is a new break in the bone, or the patient is pregnant.

Following a decision by the evaluation board, as from 1st April 2013 CT-based pain relief can only be provided for patients with statutory health insurance in the context of a multimodal pain relief concept. In this case, we will need a referral from a doctor with the advanced training qualification “Pain Relief Management” in accordance with the quality control agreement of § 135 Section 2 SGB V or the advanced training regulations.

The treatment is possible whenever medically indicated and after consultation with your doctor, as individual health care (IGeL) for self-pay patients.

Preparation

 

Planning the therapy

In order to assess the indication, we require current imaging by means of MRT (no older than 3 months).

The doctor treating you will explain the exact course of CT-based pain therapy in a personal consultation. Please bring your current coagulation values (Quick, PTT, thrombocytes) with you to this consultation.

Preparation at home

Patients taking anticoagulant medication (e.g. ASS, Plavix) should interrupt the course after consultation with their doctor.

If you are taking Marcumar (Falithrom), it should be changed to Heparin injections.

Please do not undergo any vaccinations during the therapy.

The therapy must be interrupted in the case of infection, when taking antibiotics and for minor out-patient operations.

Please do not fast before your treatment: you can eat and drink normally before it!

Please bring with you:

  • A towel
  • Extra socks

Procedure

 

CT-based pain therapy is given in a series of six treatment sessions maximum, at an interval of one to two weeks.

You will be treated while lying on your stomach on the examination table.

Systematic, individual sectional images will be made using CT in order to plan your treatment. After corresponding measurement, the point of puncture will be marked on your skin. Subsequently, the place of puncture will be disinfected several times and covered with sterile dressing, and the hollow needle (cannula) will be set. As a rule, the procedure will not cause much pain.

Before injecting the medication, the position of the cannula will be checked on the basis of CT, and a correction will be made if necessary. After the medication has been administered and the needle removed, your wound will be dressed with a plaster. The therapy session will be followed by an observation period of half an hour.