[Conservative and minimally invasive treatment modalities at the spine]

Approximately 65 to 80% of the population will be afflicted with low-back pain during their life and about 14% indicate discomfort which continues longer than 14 days. Different percutaneous treatment modalities as a minimal invasive method have been established as a complement to the conservative therapy as well as a means for differential diagnosis of indistinct pain syndromes. Nevertheless, this form of pain therapy is to be classified as an invasive method and may be used only in properly selected patients. In addition, many preliminary investigations by an interdisciplinary team are necessary. This ensures, at the same time, the evaluation of the therapy success and the decision on the subsequent therapy. In the present review I provide a comprehensive review of the indications for treatment, different treatment strategies, and the combination of pain and depression. In detail, the article deals with facet and sacroiliac joint injections, sympathetic blocks, vertebroplasty, kyphoplasty, percutaneous disc treatment procedures, and endovascular embolization of highly vascularised tumours of the spine.