Section 1: Introduction
1. Introduction: How to Use This Atlas
2. Needle Techniques
3. Fluoroscopic Techniques: Anatomy and Set-Up
4. Ultrasound Techniques and Pearls
5. Optimizing Patient Safety and Positioning
6. Radiation Safety
Section 2: Sacral/Coccygeal
7A Caudal Epidural Steroid Injection--Shallow Angle Approach: Fluoroscopic Guidance
7B Caudal Epidural Spinal Injection--Steep Angle Approach: Fluoroscopic Guidance
7C Caudal Epidural Steroid Injection: Ultrasound Guidance
8A Ganglion Impar Injection: Fluoroscopic Guidance
8B Ganglion Impar Injection: Ultrasound Guidance
9. Sacral Insufficiency Fracture Repair/Sacroplasty: Fluoroscopic Guidance
10A Sacroiliac Intraarticular Joint Injections--Posterior Approach, Inferior Entry: Fluoroscopic Guidance
10B Sacroiliac Intraarticular Joint Injection: Ultrasound Guidance
11. S1 Transforaminal Epidural Steroid Injection
Section 3: Lumbar/Lumbosacral
12. Lumbar Interlaminar Epidural Steroid Injection--Paramedian Approach: Fluoroscopic Guidance
13A Lumbar Transforaminal Epidural Steroid Injection--Supraneural, Traditional Single-Needle Technique: Fluoroscopic Guidance
13B Lumbar Transforaminal Epidural Steroid Injection--Supraneural, Two-Needle Technique: Fluoroscopic Guidance
13C Lumbar Transforaminal Epidural Steroid Injection--Infraneural: Fluoroscopic Guidance
13D Lumbar Transforaminal Epidural Steroid Injection--Needle Localization Diagrams
14. Lumbar Myelography: Fluoroscopic Guidance
15A Lumbar Zygapophysial Joint Intraarticular Joint Injection--Posterior Approach: Fluoroscopic Guidance
15B Lumbar Zygapophysial Joint Nerve (Medial Branch) Injection--Oblique Approach: Fluoroscopic Guidance
15C Lumbar Zygapophysial Joint Nerve (Medial Branch) Radiofrequency Neurotomy, Posterior Approach: Fluoroscopic Guidance
15D Lumbar Medial Branch Blocks--Midline: Ultrasound Guidance
15E Lumbar Zygapophysial Joint Innervation--Anatomy Diagram and Lesion Zone Diagram
16. Lumbar Sympathetic Block: Fluoroscopic Guidance
17A Lumbar Provocation Discography/Disc Access: Standard Fluoroscopic Techniques
17B L5-S1 Disc Access: Fluoroscopic Guidance
Section 4: Thoracolumbar
18. Thoracolumbular Spinal Cord Stimulation: Fluoroscopic Guidance
19. Vertebral Augmentation (Vertebroplasty/Kyphoplasty), Transpedicular Approach: Fluoroscopic Guidance
Section 5: Thoracic
20. Thoracic Interlaminar Epidural Steroid Injection--Paramedian Approach, Fluoroscopic Guidance
21. Thoracic Transforaminal Epidural Steroid Injection--Infraneural Approach
22A Thoracic Zygapophysial Joint Intraarticular Injection--Posterior Approach: Fluoroscopic Guidance
22B Thoracic Zygapophysial Joint Nerve (Medial Branch) Injection--Posterior Approach: Fluoroscopic Guidance
22C Thoracic Zygapophysial Joint Nerve (Medial Branch) Radiofrequency Neurotomy--Posterior Approach: Fluoroscopic Guidance
22D Thoracic Zygapophysial Joint Innervation--Anatomy Diagram
23A Intercostal Nerve Injections: Fluoroscopic Guidance
23B Intercostal Nerve Injection--In-Plane Approach: Ultrasound Guidance
24. Thoracic Disc Access: Fluoroscopic Guidance
Section 6: Cervical
25. Cervical Interlaminar Epidural Steroid Injection--Paramedian Approach: Fluoroscopic Guidance
26. Cervical Spinal Cord Stimulation, Fluoroscopic Guidance
27. Cervical Transforaminal Epidural Steroid Injection: Fluoroscopic Guidance
28A Stellate Ganglion Injection: Fluoroscopic Guidance
28B Stellate Ganglion Injection: Ultrasound Guidance
29. Cervical Discography/Disc Access
30A Cervical Zygapophysial Joint Intraarticular Injection--Posterior Approach: Fluoroscopic Guidance
30B Cervical Zygapophysial Joint Intraarticular Injection--Lateral Approach: Fluoroscopic Guidance
30C Cervical Zygapophysial Nerve (Medial Branch) Injection--Lateral Approach: Ultrasound Guidance
30D Cervical Zygapophysial Joint Nerve (Medial Branch) Injection--Lateral Approach: Fluoroscopic Guidance
30E Cervical Zygapophysial Joint Intraarticular Injection--Posterior Approach: Ultrasound Guidance
30F Cervical Zygapophysial Joint Nerve (Medial Branch) Radiofrequency Neurotomy and Nerve Injection--Posterior Approach: Fluoroscopic Guidance
30G Cervical Zygapophysial Joint Nerve (Medial Branch) Radiofrequency Neurotomy and Nerve Injection--Posterior Approach: Ultrasound Guidance
30H Cervical Zygapophysial Joint Innervation--Anatomy Diagram and Lesion Zone Diagrams
31. Atlantoaxial Joint Intraarticular Injection: Fluoroscopic Guidance
32. Atlantooccipital Joint Intraarticular Injection: Fluoroscopic Guidance
33. Greater Occipital Nerve Steroid Injection–In Plane Approach: Ultrasound Guidance
Section 7: Additional Image-Guided Procedures for the Spine Care and Pain Specialist: Spine Pain Mimickers
Shoulder Region
34A Shoulder/Glenohumeral Joint Intraarticular Injection--Anterior Approach: Fluoroscopic Guidance
34B Intraarticular Shoulder/Glenohumeral Joint Injection--Posterior Approach: Ultrasound Guidance
34C Shoulder/Subacromial/Subdeltoid Injection--Lateral Approach: Ultrasound Guidance
34D Shoulder/Acromioclavicular Joint Injection--Posterior Approach: Ultrasound Guidance
34E Shoulder/Suprascapular Nerve Injection--Posterior Approach: Ultrasound Guidance
34F Shoulder/Biceps Tendon Sheath Injection--Anterior Approach: Ultrasound Guidance
Hip Region
35A Intra-articular Hip Injection--Anterior Approach: Fluoroscopic Guidance
35B Intra-articular Hip Injection--Lateral Approach: Fluoroscopic Guidance
35C Intraarticular Hip Injection--Anterior Approach: Ultrasound Guidance
35D Greater Trochanteric/Gluteus Medius Injection: Ultrasound Guidance
35E Lateral Femoral Cutaneous Nerve Injection: Ultrasound Guidance
36A Iliac Crest Biopsy/Aspiration: Fluoroscopic Guidance
36B Iliac Crest Biopsy: Ultrasound Guidance
Appendix
Spine Intervention References and Tables