Interventionelle Schmerzbehandlung in der Radiologie

Schmerzen treten im Zusammenhang mit verschiedenen gut- und bösartigen Erkrankungen auf und sind oft schwierig zu behandeln. Bei vielen Patienten erfordern sie eine multidisziplinäre Herangehensweise. Interventionell-radiologische Techniken sind ein etablierter Teil der modernen Schmerztherapie und bieten eine Behandlungsoption bei Patienten, bei denen die konventionelle medikamentöse Schmerztherapie ausgeschöpft ist.

Abstract

Pain is a symptom that can be associated with both benign and malignant conditions. Pain treatment can be challenging and often requires a multidisciplinary approach. Radiologists play an important role in interventional pain management, which offers treatment options for patients who have not responded to conventional drug therapy. The article discusses established interventional radiology procedures for the diagnosis and treatment of pain, with a focus on the treatment of back pain.

Schlüsselwörter

Schmerztherapie - periradikuläre Therapie - Facetteninfiltration - Vertebroplastie - Tumorablation

Keywords

pain management - periradicular therapy - facet joint infiltration - vertebroplasty - tumor ablation

Publication History

Article published online:
03 June 2025

• Literatur

• 1 Von der Lippe E, Krause L, Prost M. et al. Prävalenz von Rücken- und Nackenschmerzen in Deutschland. Ergebnisse der Krankheitslast-Studie BURDEN 2020. Robert Koch-Institut 2021;
• 2 Bauones S, Cazzato RL, Dalili D. et al. Precision pain management in interventional radiology. Clin Radiol 2023; 78: 270-278
• 3 MacMahon PJ, Huang AJ, Palmer WE. Spine Injectables: What Is the Safest Cocktail?. AJR Am J Roentgenol 2016; 207: 526-533
• 4 Hidalgo-Tallón FJ, Torres-Morera LM, Baeza-Noci J. et al. Updated Review on Ozone Therapy in Pain Medicine. Front Physiol 2022; 13: 840623
• 5 Manchikanti L, Buenaventura RM, Manchikanti KN. et al. Effectiveness of therapeutic lumbar transforaminal epidural steroid injections in managing lumbar spinal pain. Pain Physician 2012; 15: E199-E245
• 6 Deer TR, Jain S, Hunter C. et al. Neurostimulation for Intractable Chronic Pain. Brain Sci 2019; 9: 23
• 7 Palmer WE. Spinal Injections for Pain Management. Radiology 2016; 281: 669-688
• 8 Peh W. Image-guided facet joint injection. Biomed Imaging Interv J 2011; 7: e4
• 9 Hansen HC, McKenzie-Brown AM, Cohen SP. et al. Sacroiliac joint interventions: a systematic review. Pain Physician 2007; 10: 165-184
• 10 Bogduk N, Dreyfuss P, Baker R. et al. Complications of Spinal Diagnostic and Treatment Procedures. Pain Med 2008; 9: S11-S34
• 11 Kim JY, Kim SN, Park C. et al. Effect of needle type on intravascular injection in transforaminal epidural injection: a meta-analysis. Korean J Pain 2019; 32: 39
• 12 Li H, An J, Zhang J. et al. Comparative efficacy of radiofrequency denervation in chronic low back pain: A systematic review and network meta-analysis. Front Surg 2022; 9: 899538
• 13 Gelalis I, Gkiatas I, Spiliotis A. et al. Current concepts in intradiscal percutaneous minimally invasive procedures for chronic low back pain. Asian J Neurosurg 2019; 14: 657-669
• 14 Prophylaxe, Diagnostik und Therapie der Osteoporose bei postmenopausalen Frauen und bei Männern ab dem 50. Lebensjahr – Leitlinie des Dachverbands der Deutschsprachigen Wissenschaftlichen Osteologischen Gesellschaften e.V. 2023; AWMF-Register-Nr.: 183/001. 2023. Im Internet (Stand: 24.12.2023) https://register.awmf.org/de/leitlinien/detail/183-001
• 15 S3-Leitlinie Supportive Therapie bei onkologischen PatientInnen; AWMF-Registernummer: 032/054OL. 2020; Im Internet (Stand: 24.12.2023) https://register.awmf.org/de/leitlinien/detail/032-054OL
• 16 Saracen A, Kotwica Z. Complications of percutaneous vertebroplasty: An analysis of 1100 procedures performed in 616 patients. Medicine (Baltimore) 2016; 95: e3850
• 17 Xiao H, Yang J, Feng X. et al. Comparing complications of vertebroplasty and kyphoplasty for treating osteoporotic vertebral compression fractures: a meta-analysis of the randomized and non-randomized controlled studies. Eur J Orthop Surg Traumatol 2015; 25: S77-S85
• 18 Health Quality Ontario. Vertebral Augmentation Involving Vertebroplasty or Kyphoplasty for Cancer-Related Vertebral Compression Fractures: A Systematic Review. Ont Health Technol Assess Ser 2016; 16: 1-202
• 19 Moynagh M, Kurup A, Callstrom M. Thermal Ablation of Bone Metastases. Semin intervent Radiol 2018; 35: 299-308
• 20 Datta R, Agrawal J, Sharma A. et al. A study of the efficacy of stellate ganglion blocks in complex regional pain syndromes of the upper body. J Anaesthesiol Clin Pharmacol 2017; 33: 534-540