Abstract
BackgroundUltrasound-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.ResultsThirty-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.ConclusionsUS-guided fluoroscopic-verified trans-foraminal PR of lumbar DRG is accurate, safe, and effective for CRP.
Highlights
Ultrasound-guided lumbar pain interventions were thought to be difficult; the high acoustic impedance of bone hides the underling structures and needle path
Many minimally invasive interventions are tried for chronic radicular pain due to disc herniation, including nerve root or epidural injection, endoscopic discectomy, spinal cord, or dorsal root ganglion (DRG) stimulation and modulation [4]
The current study investigated the accuracy and safety of US-guided trans-foraminal lumbar dorsal root ganglion in management of chronic radicular pain (CRP) with subsequent fluoroscopy (FL) confirmation
Summary
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. Many minimally invasive interventions are tried for chronic radicular pain due to disc herniation, including nerve root or epidural injection, endoscopic discectomy, spinal cord, or dorsal root ganglion (DRG) stimulation and modulation [4]. DRGs are 31 pairs and convey all sensory information including pain from the periphery to the spinal cord. Mechanical compression or irritation to DRGs liberates pain mediators and
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