Sequence of a CT-guided pain therapy

If a referral for CT-guided pain therapy has been made to an appropriately equipped practice or clinic, an informative discussion with the doctor is first held there before the first treatment. The patient then lies down on the computer tomography table for the therapy. Treatment of the lumbar spine is carried out in a prone position, while therapy of the thoracic or cervical spine requires a supine position.

The treatment itself is carried out by placing a thin needle over the skin up to the point of pain. Simultaneous computer tomography is used for imaging and visual control of the needle within the body. The puncture into the skin can be compared to taking a blood sample and is therefore only slightly painful.

As soon as the needle is correctly placed, an analgesic and usually a cortisone preparation are administered via the needle. These are so-called depot medications, i.e. the effect is released slowly and continuously over a longer period of time. The dose is chosen individually and depends, among other things, on the intensity of the pain.

The next treatment takes place after about two to six weeks. How many treatments are carried out also depends on the individual. Usually between two and eight appointments are chosen.

After the treatment, it is recommended to be brought home by an accompanying person. However, the patient should first remain in the practice for 15 to 30 minutes for monitoring. If you want to drive yourself, you must wait at least 30 to 60 minutes after the injection has been placed.

In addition, one should not drive a car if there are sensory disturbances or sensations in the leg. Furthermore, heavy physical activity should be avoided on the day of treatment. However, there are no other restrictions on everyday life.

Risks of CT-guided pain therapy

The risks of complications with CT-guided pain therapy are rather low. Very rarely, for example, there may be bleeding or infection due to the puncture. The occurrence of an allergic reaction is also rare.

Extremely rarely, permanent damage such as paralysis occurs due to nerve injury. Depending on where the operation is performed, there is a risk of injury to neighbouring organs. In the area of the thoracic spine, an accidental puncture of the pleura can cause the lung to collapse (pneumothorax), which would make hospital treatment necessary. Possible but also very rare in the lumbar region are injuries to blood vessels, intestinal loops or the kidneys, which in extreme cases can lead to complications such as blood poisoning, peritonitis or a stroke. The radiation exposure resulting from computer tomography (CT) is very low with this treatment and the benefits usually outweigh the risks.