Abstract
Ultrasound-guided injections are an alternative to evaluate in the management of low back pain associated with osteoarthritis of the lumbar facet joints: it eliminates the risk of ionizing radiation for both the patient and the practitioner. This study aims to compare the short-term clinical efficacy of lumbar facet joints injections between ultrasound-guided injections and fluoroscopy-guided injections. Observational, retrospective, single-center study. Patients received one or two lumbar zygapophyseal joints injections under fluoroscopy or ultrasound and a follow-up consultation at one month. Data from 54 patients was collected. The median of the evolution of VAS at one month was − 30 mm [−50.0; −20.0] in the ultrasound group and – 29.5 mm [−47.0; −15.0] (p < 0.001) in the fluoroscopy group with no statistically significant difference between the two groups (p = 0.835). There were no injection-related complications in either group during the follow-up. The percentage of patients who stopped NSAIDs was not statistically significant between the two groups (p = 1.00). Injections of corticosteroids of lumbar facet joints under ultrasound guidance significantly reduced pain after one month, with no difference found between the two techniques. Ultrasound-guided injections are reliable, accessible and a safe alternative that should be preferred over those under fluoroscopy.
Highlights
Ultrasound-guided injections are an alternative to evaluate in the management of low back pain associated with osteoarthritis of the lumbar facet joints: it eliminates the risk of ionizing radiation for both the patient and the practitioner
It seems interesting to study a comparable alternative in terms of efficacy and tolerance to infiltrations under fluoroscopy, accessible to any rheumatologist trained in osteoarticular ultrasound
The inclusion criteria were the following: age > 18 years, chronic lumbar pain with facet syndrome diagnosis by the rheumatologist, patients having received from one or two injections of lumbar zygapophyseal joints under fluoroscopy or under ultrasound in the Department of Rheumatology at the University Hospital of Amiens from November 2018 to January 2020, patients who have benefited from a one-month follow-up consultation
Summary
Ultrasound-guided injections are an alternative to evaluate in the management of low back pain associated with osteoarthritis of the lumbar facet joints: it eliminates the risk of ionizing radiation for both the patient and the practitioner. This study aims to compare the short-term clinical efficacy of lumbar facet joints injections between ultrasound-guided injections and fluoroscopy-guided injections. Injections of corticosteroids of lumbar facet joints under ultrasound guidance significantly reduced pain after one month, with no difference found between the two techniques. According to a meta-analysis carried out in 2016 only three studies (with a total of 202 patients) investigated the effectiveness of identifying lumbar zygapophyseal joints with ultrasound in comparison with scopic spotting that is still the preferred technique in use today[12]. The main objective of this study was to compare the short-term efficacy of injections of lumbar facet joints in the management of low back pain between ultrasound-guided injections and fluoroscopy-guided injections
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