Ultrasound Guided Versus CT-Controlled Pararadicular Injections in the Lumbar Spine: A Prospective Randomized Clinical Trial

作者：Loizides A^*; Gruber H; Peer S; Galiano K; Bale R; Obernauer J

来源：American Journal of Neuroradiology, 2013, 34(2): 466-470.

DOI：10.3174/ajnr.A3206

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. We conducted this study to evaluate the accuracy, time savings, radiation doses, and pain relief of US-guided pararadicular injections versus CT-controlled interventions in the lumbar spine in a prospective randomized clinical trial. %26lt;br%26gt;MATERIALS AND METHODS: Forty adult patients were consecutively enrolled and assigned to a US or CT group. US-guided pararadicular injections were performed on a standard US device by using a broadband curved-array transducer (9-4 or 5-1 MHz). In the in-plane technique, the needle was advanced through the respective segmental intertransverse ligament. The needle tip position was verified by CT. The CT-guided approaches were performed under standardized procedures by using the CT-positioning laser function. %26lt;br%26gt;RESULTS: The accuracy of US-guided interventions was 90%. The mean time to final needle placement in the US group was 4.0 1.8 minutes, and in the CT group, 7.6 +/- 2.1 minutes. The mean radiation doses, including CT confirmation for study purposes only, were 20.3 +/- 9.0 mGy cm for the US group and 42.6 +/- 36.1 mGy cm for the CT group. Both groups showed the same significant pain relief (P %26lt; .05) without relevant intermethodic differences of pain relief (P %26gt; .05). %26lt;br%26gt;CONCLUSIONS: US-guided pararadicular injections show a therapeutic effect similar to that in the time-consuming, expensive, ionizing CT or fluoroscopically guided pararadicular injections and result in a significant reduction of procedure time expenditure and avoidance of radiation.

• 出版日期2013-2