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imaging studies, 41-43 implanted drug delivery systems, 273-291 intrathecal infusion techniques, 52 laboratory tests, 44 local anesthetics, 48-49, 49t medical therapies, 47-51 membrane-stabilizing agents, 48

nerve blocks, 44-46,

149-170 neural blockade, 51 neurodestructive techniques, 51

neuropathic, 277

treatment algorithm, 39 nonionic contrast agents, allergic reaction to, 34 nonsteroidal anti-

inflammatory drugs, 48 as cytochrome c oxidase enzyme block, 48 opioids, 50

oxygen-ozone, intradiscal, for herniated disc, 349-358 patient evaluation, 37-52 patient history, 40 phantom limb, 34 pharmacological agents, 30-35 physical examination, 41 physical medicine, 51 procedure selection criteria, 47-52

psychological evaluation,

46-47 rehabilitation, 51 sacroiliac joint injection,

234-244 screening for, 44 spinal cord stimulation, 51-52

steroid injections, epidural,

149-170 of terminal disease, World Health Organization treatment ladder, 39 thermography, 42-43 topical agents, 50 transcutaneous electrical nerve stimulation, 46 treatment targets, 38 tricyclic antidepressants, 48 types of, characteristics of, 277

vertebral compression fracture, 334 vertebroplasty, percutaneous, 245-272 visceral, 277 zygapophyseal joints as source of, 56 Paraspinal biopsy approach, bone, 75 Paraspinal oblique biopsy approach, disc, 75 Parkes-Weber syndrome, 306 Pars interarticularis defects, in radiograph, 41 Pathological filling defects, structural abnormalities producing, 173 Patient evaluation, 37-52 biological aspects of pain, 40 diagnostic nerve blocks, 44-46

central nerve blocks, 45-46 peripheral nerve blocks, 45

Patient evaluation (Continued) electrodiagnostics, 43-44 electromyography, 43 nerve conduction studies, 44 history taking, 40 imaging studies, 41-43 bone scanning, 42 computed tomography scanning, 42 magnetic resonance imaging, 42 myelography, 42 radiographs, conventional, 41

thermography, 42-43 ultrasound, 42 laboratory tests, 44

screening, 44 physical examination, 41 psychological evaluation, 46-47 anxiety, 46 depression, 46 treatment targets, 38 Patient history, 40 Penicillin, as antibiotic, 32 Percocet, for analgesia, 33 Percodan, for analgesia, 33 Percodone, for analgesia, 33 Percutaneous implanted drug delivery systems, 280 Percutaneous spinal biopsy, image-guided, 69-93 anterolateral, soft tissues, 75 approaches to, 75 biopsy needle systems, 73 biopsy techniques, 75-91,

76-88, 90-91 coaxial needle systems, 74 commercially available biopsy systems, 74 complications of, 71 equipment, 73-75, 74, 74t fluoroscopy, 73 imaging guidance modalities, 73 indications for, 70 magnetic resonance imaging, 73

paraspinal, bone, 75 paraspinal oblique disc, 75 paraspinal, 75 patient preparation, 70t, 71t, 71-72, 71-73

posterolateral bone, 75 disc, 75 soft tissues, 75 postoperative care, 91-92 transcostovertebral, bone, 75 transpedicular, bone, 75 Percutaneous vertebroplasty, 245-272 anesthesia, 258-259, 258t antibiotics, 258 cement injection, 262-264, 263

cement selection, preparation, 254-255, 255 complications of, 268-269 image guidance, 256-258, 257 biplane fluoroscopy/angiograph y, 256-258 informed consent issues, 256 laboratory evaluations, 257 local anesthetic solutions,

258-259 needle introduction, placement, 259-261, 260-262 postoperative care, 264-266, 265, 266t sample orders, 266t procedure results, 266-267 technique, 256-264 venography, 262 workup of patient, 246-253, 247-249, 251-253 Peripheral nerve blocks, diagnostic, 45 Phantom limb pain, 34 Pharmacological agents, 30-35. See also under drug name analgesics, 32-34 anesthetic agents, 31-32 antibiotics, 32 corticosteroids, 30-31 epidural steroid injections,

149-170 mechanisms of action of, 49 Phenytoin for depression, 34 mechanism of action, 49 Physical examination of patient, 41. See also Patient evaluation Physical medicine, 51 cold application, 51

electrical stimulation, for muscle spasm, 51 gait abnormalities, correction of, 51 heat application, 51 strengthening exercises, 51 stretching exercises, 51 ultrasound, with muscle spasm, 51 Pial arteriovenous fistula,

296-298, 297 Pocket, movement of pump in, as implanted drug delivery complication, 288-289 Posterolateral biopsy approach bone, 75 disc, 75 soft tissues, 75 Postherpetic neuralgia, tricyclic antidepressants for, 34. See also under drug name Pretransverse arteries, spine, 16 Procedure selection criteria algorithm for pain management, 39 alternative medications, 50 antiepileptic agents, 48 anxiolytic medications, 50 botulinum toxins, 50-51 facet rhizolysis, 51 follow up, 52 interventions, 51-52 intrathecal infusion techniques, 52 local anesthetics, 48-49, 49t medical therapies, 47-51 membrane-stabilizing agents, 48

neural blockade, 51 neurodestructive techniques, 51

nonsteroidal anti-

inflammatory drugs, 48 opioids, 50

exclusion, inclusion criteria, 278 pharmaceuticals, mechanism of action, 49 physical medicine, 51 spinal cord stimulation, 51-52

terminal disease pain, World Health Organization treatment ladder for, 39

topical agents, 50 transcutaneous electrical nerve stimulation, 46 tricyclic antidepressants, 48 anticholinergic effects of, 48

Programmable pump, for drug delivery, 274-275, 282 Prostaglandins, amplification of pain with, 48 Prostatic hypertrophy, patients with, 48 Psychological evaluation, 46-47 anxiety, 46 depression, 46 Pump, for drug delivery constant flow rate, 274, 281-282 programmable, 274-275, 282

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Eliminating Stress and Anxiety From Your Life

Eliminating Stress and Anxiety From Your Life

It seems like you hear it all the time from nearly every one you know I'm SO stressed out!? Pressures abound in this world today. Those pressures cause stress and anxiety, and often we are ill-equipped to deal with those stressors that trigger anxiety and other feelings that can make us sick. Literally, sick.

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