Journal of Pain Research (Mar 2023)
Interventional Pain Procedures: A Narrative Review Focusing On Safety and Complications. PART 2 Interventional Procedures For Back Pain
Abstract
Giuliano Lo Bianco,1,2 Andrea Tinnirello,3 Alfonso Papa,4 Maurizio Marchesini,5 Miles Day,6 Gaetano Joseph Palumbo,7 Gaetano Terranova,8 Maria Teresa Di Dato,4 Simon J Thomson,9 Michael E Schatman10,11 1Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy; 2Anesthesiology and Pain Department, Fondazione Istituto G. Giglio, Cefalù, Italy; 3Anesthesiology and Pain Medicine Department, ASST Franciacorta, Ospedale di Iseo, Iseo, 25049, Italy; 4Pain Department, AO “Ospedali dei Colli”, Monaldi Hospital, Naples, Italy; 5Mininvasive Surgery Department, Unit of Pain Medicine IRCCS Maugeri Pavia, Pavia, 27100, Italy; 6Pain Research, The Pain Center at Grace Clinic, Texas Tech University HSC, Lubbock, TX, USA; 7Azienda Ospedale - Università Padova, Department of Anesthesia and Intensive Care, Padova, Italy; 8Anaesthesia and Intensive Care Department, Asst Gaetano Pini, Milano, Italy; 9Pain Management, Mid and South Essex University Hospitals NHSFT, Basildon, SS16 5NL, UK; 10Department of Anesthesiology, Perioperative Care, and Pain Medicine, NYU School of Medicine, New York, NY, USA; 11Department of Population Health – Division of Medical Ethics, NYU School of Medicine, New York, NY, USACorrespondence: Giuliano Lo Bianco, Email [email protected]: In patients where conservative approaches have failed to relieve from chronic pain, interventional procedures may be an option in well selected patients. In recent years there has been an increase in the use and development of invasive procedures. Concomitantly, there has also been an increase in the complications associated with these procedures. Taken this into consideration, it is important for healthcare providers to take a cautious and vigilant approach, with a focus on patient safety, in order to minimize the risk of adverse events and ensure the best possible outcome for the patient. This may include careful selection of patients for procedures, use of proper techniques and equipment, and close monitoring and follow-up after the procedure. The aim of this narrative review is to summarize the primary complications associated with commonly performed image-guided (fluoroscopy or ultrasound-guided) interventional procedures and provide strategies to reduce the risk of these complications. We conclude that although complications from interventional pain procedures can be mitigated to a certain degree, they cannot be eliminated altogether. In order to avoid adverse events, patient safety should be given considerable attention and physicians should be constantly aware of the possibility of developing complications.Keywords: chronic pain, pain management procedures, complications, spinal cord stimulation, intrathecal drug delivery, low back pain