767 - Image-Guided Interventional Radiology Procedures for Pediatric Back Pain

Learning Objectives:

• To illustrate through case presentation the importance of Interventional Radiology (IR) image guided-procedures in evaluation and management of pediatric specific back pain.


• Raise awareness of image-guided procedures specific to pediatric back pain diagnosis, therapeutic pain relief, surgical planning, and post-operative management.


• Emphasize the value of multidisciplinary collaboration, and pediatric-specific safety considerations.

Background: Back related pain in children and adolescents is a growing concern, often requiring a nuanced approach distinct from adults. IR can be essential in assisting with pediatric back pain through image-guided techniques. Awareness and understanding of common pediatric spinal pain etiologies including disc pathologies, central canal stenosis, radiculopathy, Bertolotti syndrome, pars defects and spondylolysis, and sacroiliac joint dysfunction is essential for effective management.

Clinical Findings/Procedure Details: We present a case series illustrating of pediatric conditions encountered, optimal imaging evaluation, and a variety of image-guided pain procedures used to successfully to manage pediatric back conditions as part of a multi-disciplinary team. Cases included: epidural steroid injections for central stenosis, transforaminal epidural steroid injections for radicular symptoms, targeted steroid injections for Bertolotti syndrome with lumbosacral transitional vertebrae, pars interarticularis defect injections for spondylolysis, sacroiliac joint injections for SI dysfunction, and diagnostic/therapeutic injections performed for surgical planning and post-operative pain management. Technique modifications for pediatric anatomy and safety considerations will be detailed.

Conclusion and/or Teaching Points: Interventional Radiology is essential in managing anatomical variations specific to pediatric back pain, providing image guided procedures for diagnosis, symptom relief, and surgical planning. Current guidelines are limited, highlighting the need for larger studies to evaluate long-term outcomes, efficacy, and safety.