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This edition of Neuroimaging Clinics focuses on these minimally invasive, image-guided therapies. It includes guidelines for patient assessment and selection, choices of pharmaceuticals and materials commonly used, as well as, advice from noted experts about complication avoidance. Common procedures such as biopsy, epidural steroid injection and vertebroplasty (or balloon assisted vertebroplasty) are discussed. Newer procedures, such as sacroplasty, synovial cyst rupture, spinal cord stimulators, neurolysis, percutaneous discectomy, and minimally invasive treatment of spinal stenosis, are introduced.