Invasive treatments

There is an inevitable overlap between these therapies and (systemic) pharmacologic treatments, which is perhaps most obvious in the use of implanted spinal drug delivery systems to increase the therapeutic effect, and/or reduce side effects, of a drug previously given systemically. Invasive treatments can be classified as follows:

• reversible local/regional block with local anesthetic, with or without the use of additional corticosteroid;

• spinal injection/infusion of some drugs considered largely effective only by this route (e.g. benzodiazepines, clonidine) or more effective/better tolerated in selected cases (e.g. opioids, baclofen);

• neurolytic procedures;

• botulinum toxin injection;

• miscellaneous.

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