Value of ultrasound-guided epidural puncture in patients with chronic axial lower back pain caused by degenerative spinal diseases

Abstract

Objective To evaluate the value of ultrasound-guided epidural puncture in the patients with chronic axial lower back pain caused by degenerative spinal diseases. Methods One hundred and sixty-eight patients with chronic axial lower back pain caused by degenerative spinal diseases, aged 47-60 yr, with body mass index of 18-25 kg/m2, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, with visual analogue scale score ≥6 and the course of the disease >3 yr, undergoing epidural puncture were randomly divided into 3 groups (n=56 each) using a random number table: hand positioning group (group H), X-ray guidance group (group X), and ultrasound guidance group (group U). The puncture site was determined by hand positioning, and the epidural puncture was performed routinely in group H. In X and U groups, the puncture site was determined under the guidance of X-ray and ultrasound, respectively, and then the epidural puncture was performed.The operating time, the number of needle insertion at the puncture site, the number of needle passing through tissues, the successful puncture at 1st attempt, and the occurrence of pain at the puncture site were recorded. Results Compared with group H, the operating time was significantly shortened, the number of needle passing through tissues was significantly decreased, the rate of successful puncture at 1st attempt was significantly increased (P 0.05). There was no significant difference in the incidence of pain occurred at the puncture site between the three groups (P>0.05). Conclusion The efficacy of epidural puncture guided by ultrasound is similar to that guided by X-ray and better than that guided by hand positioning in the patients with chronic axial lower back pain caused by degenerative spinal diseases. Key words: Ultrasonography; Spinal diseases; Injections, epidural; Low back pain; Back pain