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Background Ultrasound-guided lumbar pain interventions were thought to be difficult; the high acoustic impedance of bone hides the underling structures and needle path. Reviewing the sonoanatomy of the lumbar region using different planes and angles made better sonographic guidance for spine injections. The aim of this prospective study is to assess the accuracy and safety of ultrasound (US)-guided lumbar trans-foraminal pulsed radiofrequency of the dorsal root ganglion confirmed by fluoroscopic imaging in management of chronic radicular pain. Results Thirty-two patients, with 34 lumbar interventions, were included in the study. Thirty-one interventions out of 34 were performed successfully with overall accuracy of 91.18% and with minimal complications. The successful first trial placement of the cannula was calculated in 44.1% of interventions; multiple trials were needed in 47.1% while incorrect level was encountered in 8.8%. Visual analogue scale of pain and Oswestry Disability Index decreased significantly after intervention up to 3 months compared to the pre-intervention value. The analgesic consumption was reduced by mean of 73.44 ± 31.07% 1 month after intervention. Conclusions US-guided fluoroscopic-verified trans-foraminal PR of lumbar DRG is accurate, safe, and effective for CRP.

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Background: Sacroiliac Joint pain is among the most prevalent causes of low back pain that must be distinguished from other types of LBP. Treatment of sacroiliac pain could be obtained by many methods involving intraarticular steroid injection or pulsed radiofrequency. Objectives: This study purposed to determine Ultrasound-Guided Radiofrequency ablation technique influence and to compare its efficacy with local steroid injection for Sacroiliac pain. Study Design: A clinical comparative study. Methods: Number of 20 patients were randomly allocated in two groups. Group I was subjected to pulsed intraarticular PRFA and group II was subjected to intraarticular steroid injection ultrasounded-guided. The Oswestry Disability Index (ODI) II and Visual Analogue Scale (VAS) were measured before intervention and on follow up immediately post intervention, 1, 3 and 6 weeks later. Results: Patients who received pulsed intraarticular RFA showed decreased pain after therapy with an average of mean ± SD of 3.5 ± 0.53 immediately post and from 4 -6 with a mean ± SD of 4.9 ± 0.88 six weeks after. Following therapy, patients who received SIJ intraarticular steroid injection reported, on average, less discomfort of 3.5 ± 0.53 immediately post and from 5 -7 with a mean ± SD of 5.8 ± 0.63 six weeks after. Conclusions: SIJ intraarticular steroid injections and SIJ pulsed RFA ,both provided considerable pain reduction in SIJafflicted individuals. SIJ pulsed RFA offered longer-lasting pain alleviation and a substantial decrease in the ODI.