Ultrasound diagnosis and therapeutic intervention in the spine

Abstract

Spine pathology afflicts people across the globe and is responsible for a large portion of physician visits and healthcare costs. Imaging such as plain radiographs, CT, MRI, and ultrasound is vital to assess structure, function, and stability of the spine and also provide guidance in therapeutic interventions. Ultrasound utilization in spine conditions is less ubiquitous, but provides benefits in low costs, portability, and dynamic imaging. This study assesses ultrasound efficacy in diagnosis and therapeutic interventions for spine pathology. A systematic review conducted via PubMed, MEDLINE, and Google Scholar identified 3,630 papers with eventual inclusion of 73 papers with an additional 21 papers supplemental papers subsequently added. Findings highlighted ultrasound utilization for different structural elements of the spine such as muscle, bone, disc, ligament, canal, and joints are presented and compared with radiographs, CT, and MRI imaging where relevant. Spinal curvature and mobility are similarly presented. Ultrasound efficacy for guided therapeutics about the spine is presented and assessed against other modalities. Ultrasound is a widely used and efficacious modality to guide injections about the spine. Diagnostic utility is less well studied, but shows promise in assessing fractures, posterior ligamentous stability, and intra-operative hardware placement. The low cost, portability, and dynamic imaging ability make it an attractive modality particularly for developing health systems and resource limited environments such as combat settings and the International Space Station. Further study is recommended before broad adoption in diagnostics.

<p>The clinical efficacy of ultrasound-guided percutaneous microwave ablation for rib metastases with severe intractable pain: a preliminary clinical study</p>

“…Most of the treatments have been performed under CT guidance, which has led to several inconveniences, such as the risk of radioactive exposure to patients and operators. Ultrasound-guided interventional therapies that are portable, have no radioactive exposure risk and have dynamic imaging abilities are an attractive modality in the clinical setting, including for use in spine disease diagnoses and therapeutic interventions 19,23. The ribs are superficial and thin structures.…”

“…Ultrasound-guided percutaneous microwave ablation (US-PMWA) has the advantages of being a real-time, convenient, lower-cost and nonradiative treatment and has been widely used for the treatment of many solid tumors in the clinical setting. Additionally, ultrasound diagnoses and therapeutic interventions for bone disease are becoming widely used with increased efficiencies. 19 The role of US-PMWA in the treatment of rib metastases for the relief of pain has not previously been studied.…”

Novel automated spinal ultrasound segmentation approach for scoliosis visualization

“…Compared with the commonly used X-ray and MRI detection methods, ultrasound has no radiation, high real-time performance, and low price ( Yang et al, 2021 ). Ultrasound is a mechanical wave generated by mechanical vibration ( Ahmed et al, 2018 ). The wave can enter the human body and pass through various tissues to generate echoes and form images through computer calculations.…”

Ultrasonographic diagnosis of lumbar disc protrusion in adolescents: comparison with MRI results

“…Along with MRI, which is the main method of IVD imaging, ultrasound (US) may be an appropriate alternative, considering its low cost, availability and well-known recognition of the possibility to obtain high-quality soft tissue images [2,3].…”