Abstract
BackgroundThe purpose of this study was to investigate the feasibility, accuracy and efficiency of the facet joint injections in the lumbar spine by ultrasound guided versus lose dose computed tomography (CT) guidance.MethodsFirst the examination on the joint space of the facet joints of the lumbar spine was obtained by the ultrasound in 10 patients. Second forty patients were randomized assigned into two groups: ultrasound group and low dose CT group. Comparison was made in the clinical efficiency between the ultrasound-guided group and CT group. The feasibility, accuracy and efficiency of the ultrasound-guided lumbar facet joint injections were also evaluated.ResultsA total of 88 lumbar facet joints from L1 to S1 were clearly visualized in the 10 patients. Both the ultrasound and the CT measurements showed the same average depth and lateral distance to the reference point (P > 0.05). And 86.5% of the facet joint injections (64/74) were correctly performed under the ultrasound guidance in the first time. The exact placement of the needle tips was evaluated by CT. After the lumbar facet joint injections, the clinical efficiency was almost the same in the ultrasound-guided group as in the CT group.ConclusionsThe lumbar facet joint space can be accurately demonstrated by ultrasound. The ultrasound-guided facet joint injection in the lumbar spine obtained almost the same satisfactory feasibility, accuracy and clinical efficiency compared with low dose CT. Ultrasound technique could provide the real-time monitoring.Trial registrationThis study was registered on Chinese Clinical Trial Registry (ChiCTR1800018819, retrospective registered on 11/10/2018).
Highlights
The purpose of this study was to investigate the feasibility, accuracy and efficiency of the facet joint injections in the lumbar spine by ultrasound guided versus lose dose computed tomography (CT) guidance
Facet joint blocks are usually performed with the help of the fluoroscopic guidance or the computed tomography (CT) scanning guidance for a precise localization of the needle tips and avoidance of complications [7,8,9]
12 facet joints could not be identified for providing a lumbar approach to the facet joint by ultrasound, but they could be identified by CT
Summary
The purpose of this study was to investigate the feasibility, accuracy and efficiency of the facet joint injections in the lumbar spine by ultrasound guided versus lose dose computed tomography (CT) guidance. Facet joint blocks are usually performed with the help of the fluoroscopic guidance or the computed tomography (CT) scanning guidance for a precise localization of the needle tips and avoidance of complications [7,8,9]. Ultrasound is not associated with an exposure to radiation, and equipment is not too expensive, which is portable and can be used as a real-time monitoring image guide tool. Ultrasound can exactly indicate the injection sites and monitor the needle insertion and the spread of local anesthetics in real time. Inaccurate positioning of a needle tip may result in an inadvertent spread of the local anesthetic into the intervertebral foramen, the epidural space, or even the subarachnoid space, which can cause some serious complications [16, 17]
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