Neuraxial Therapeutics

Book excerpt: This book is a comprehensive reference of the neuraxial route for the delivery of therapeutics. It reviews the historical evolution of this approach from its inception in the later 1800's to present day. This amply referenced text covers basic discussions of spinal anatomy, embryogenesis, neuraxial vascularity, cerebrospinal fluid flow dynamics and parenchymal molecule movement. The pharmacokinetic and pharmacodynamic properties of different intrathecal agents are explored in detail with particular reference to clinical correlates in pain and spasticity. Particular attention is paid to the issues relevant to preclinical models of intrathecal delivery and the assessment of spinal pathologies arising from acute and chronic intrathecal drug delivery. Chapters provide essential discussions of clinical aspects of patient care, including patient evaluation and screening, trialing and device management, troubleshooting problems and addressing complications, best practices, cost-effectiveness and future of the therapy. Clinicians and researchers who practice intrathecal therapy and study neuraxial mechanisms will find Neuraxial Therapeutics, to be an invaluable guide to this treatment modality.