The most common diagnostic neuroradiology invasive procedure is the lumbar puncture (under fluoroscopic guidance) with variations of what you do with that needle: diagnostic LP for CSF sampling and pressure measurement, large volume LP for diagnostic/temporary therapeutic effect in normal pressure hydrocephalus and other causes of communicating hydrocephalus, instillation of contrast for fluoro and CT myelography to evaluate stenoses or CSF leaks, instillation of intrathecal chemotherapy for CNS lymphomas or other malignancies, instillation of the oligonucleotide nusinersen for treatment of spinal muscular atrophy, and maybe placement of a lumbar drainage catheter. Every diagnostic neurorads should be competent doing this.
Many spine procedures are niche enough that not every fellowship in these fields will prepare you. Some diagnostic neurorad programs do a bunch of spine procedures, whereas at other institutions, it's the MSK rads or the IRs. Maybe the anesthesiology interventional pain docs take most of the volume. The involvement of interventional neurorads probably depends on the balance of rads vs. neurosurgeons or neurologists involved in the program; the more radiologists, the more likely to have spine procedures while the more non-rads, the more exclusively endovascular it is.
Those other spine procedures include vertebral augmentation (kyphoplasty, vertebroplasty, sacroplasty), epidural steroid/anesthetic injection, nerve root steroid/anesthetic injection, facet joint/medial branch steroid/anesthetic injection, epidural blood patch injection, facet cyst aspiration or rupture, vertebral biopsy, vertebral tumor ablation.
