Ultrasound Guidance for Facet Joint Injections in the Lumbar Spine: A Computed Tomography-Controlled Feasibility Study

Galiano, Klaus; Obwegeser, Alois Albert; Bodner, Gerd; Freund, Martin C.; Maurer, Herbert; Kamelger, Florian; Schatzer, Reinhold; Ploner, Franz

doi:10.1213/01.ane.0000158609.64417.93

Cited by 105 publications

(68 citation statements)

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“…In the past, ultrasound (US) has been demonstrated to facilitate the localization and imaging of peripheral nerves, spinal nerve roots and also bony parts of the spine such as facet joints. US-guided approaches tailored for spinal interventions are already available, but only proven for their topographic feasibility [7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided versus computed tomography-controlled periradicular injections in the middle and lower cervical spine: a prospective randomized clinical trial

et al. 2013

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Purpose We conducted this study to evaluate accuracy, time saving, radiation doses, safety, and pain relief of ultrasound (US)-guided periradicular injections versus computed tomography (CT)-controlled interventions in the cervical spine in a prospective randomized clinical trial. Methods Forty adult patients were consecutively enrolled and randomly assigned to either a US or a CT group. USguided periradicular injections were performed on a standard ultrasound device using a broadband linear array transducer. By basically following the osseous landmarks for level definition in ''in-plane techniques'', a spinal needle was advanced as near as possible to the intended, US-depicted nerve root. The respective needle tip positioning was then verified by CT. The control group underwent CT-guided injections, which were performed under standardized procedures using the CT-positioning laser function. Results The accuracy of US-guided interventions was 100 %. The mean time to final needle placement in the US group was 02:21 ± 01:43 min:s versus 10:33 ± 02:30 min:s in the CT group. The mean dose-length product radiation dose, including CT confirmation for study purposes only, was 25.1 ± 16.8 mGy cm for the US group and 132.5 ± 78.4 mGy cm for the CT group. Both groups showed the same significant visual analog scale decay (p \ 0.05) without ''inter-methodic'' differences of pain relief (p [ 0.05). Conclusions US-guided periradicular injections are accurate, result in a significant reduction of procedure expenditure under the avoidance of radiation and show the same therapeutic effect as CT-guided periradicular injections.

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Section: Introductionmentioning

confidence: 99%

Ultrasound-guided versus computed tomography-controlled periradicular injections in the middle and lower cervical spine: a prospective randomized clinical trial

et al. 2013

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“…[7][8][9][10] US guidance for spinal injection is a recent development but, according to the literature, seems promising. [11][12][13][14][15][16][17][18][19][20] US has proved sufficiently reliable and accurate in the demonstration of lumbar paravertebral anatomy, [11][12][13][14]21 and the feasibility of US-guided injection therapy at the spine has also been demonstrated in several studies. [11][12][13][14][15][16][17][18][19][20] Although US is considered reliable for different injection procedures of the lumbar spine, [11][12][13][14] some disadvantages of the currently proposed methods-particularly in the upper lumbar spine-have been discussed.…”

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A New Simplified Sonographic Approach for Pararadicular Injections in the Lumbar Spine: A CT-Controlled Cadaver Study

Loizides¹,

Gruber²,

Peer³

et al. 2011

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Injection therapies play a major role in the treatment of lower back pain and are to date performed mainly under CT or fluoroscopic guidance. The benefits of US-guided instillation procedures have been shown in many studies. We conducted this study to simplify an US-guided approach to the lumbar spinal nerves and to assess the feasibility and preliminary accuracy by means of CT and anatomic dissection.

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“…No es recomendable el uso de analgesia en el test de bloqueo facetario debido a los falsos positivos que se pueden ocasionar. El uso de benzodiacepinas puede ser necesario en determinados pacientes [7][8][9]12,13,16,[30][31][32][33][34][35][36][37] .…”

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Abordaje intervencionista del síndrome facetario lumbar: Denervación con radiofrecuencia

et al. 2017

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IntroducciónEl dolor de espalda, en especial en columna lumbar, afecta a un alto porcentaje de la población y presenta un significativo impacto socioeconómico, con altas tasas de ausentismo y bajas laborales. En torno al 70-80% de la población de países desarrollados padece lumbalgia o lumbociatalgia en alguna ocasión a lo largo de su vida, constituyendo el motivo de consulta más frecuente tanto en atención primaria como en otras especialidades como rehabilitación, cirugía ortopédica y reumatología. En los Estados Unidos la prevalencia de dolor crónico de espalda es superior al 10%. Hasta un cuarto de la población sufre al menos un episodio de dolor lumbar al año [1][2][3][4][5] . El síndrome facetario lumbar se encuentra dentro Resumen. El dolor lumbar es una entidad común y frecuente crónica. Se estima que el dolor de causa articular facetaria representa el 15-31% de todas las consultas por dolor lumbar. En sospecha de dolor articular facetario se recomienda realización de bloqueos nerviosos para establecer el diagnóstico. La radiofrecuencia continua percutánea es el tratamiento más efectivo hasta la fecha. Se describe la evidencia actual en el tratamiento mínimamente invasivo del síndrome facetario lumbar y nuestra experiencia con las guías de imagen con TC y fluoroscopía mediante rizolisis de la rama medial del ramo primario dorsal del nervio espinal.Palabras clave: Dolor lumbar, Tratamiento con radiofrecuencia, Bloqueo nervioso.de las etiologías estructurales de dolor de espalda. Su prevalencia como causa de dolor lumbar está entre el 15-31% 3 con incidencia a lo largo de la vida de hasta el 52% en algunas series [6][7][8][9][10] . Su causa es la degeneración de las articulaciones facetarias, las cuales sufren los cambios propios de cualquier articulación sinovial. Clínicamente cursa con dolor lumbar de características mecánicas que aumenta con los movimientos de rotación y flexo-extensión (en especial en hiperextensión). No es rara su irradiación a nalgas y cara posterior de muslos. El comienzo y el curso suelen ser insidiosos, aunque muchos pacientes lo refieren a raíz de un esfuerzo brusco 1 . Actualmente no existen criterios diagnósticos aceptados del síndrome facetario. Debe valorarse Martínez A. et.al. Abordaje intervencionista del síndrome facetario lumbar. Rev Chil Radiol 2017; 23(1): 7-14. Correspondencia: Alberto Martínez-Martínez / rralbert.martinez@gmail.com Trabajo recibido el 27 de agosto de 2016. Aceptado para publicación el 17 de marzo de 2017.

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Ultrasound Guidance for Facet Joint Injections in the Lumbar Spine: A Computed Tomography-Controlled Feasibility Study

Cited by 105 publications

References 11 publications

Ultrasound-guided versus computed tomography-controlled periradicular injections in the middle and lower cervical spine: a prospective randomized clinical trial

Ultrasound-guided versus computed tomography-controlled periradicular injections in the middle and lower cervical spine: a prospective randomized clinical trial

A New Simplified Sonographic Approach for Pararadicular Injections in the Lumbar Spine: A CT-Controlled Cadaver Study

Abordaje intervencionista del síndrome facetario lumbar: Denervación con radiofrecuencia

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