Symptoms improved more rapidly than function after surgery. Measurement of the ultrasonographic CSA ratio may provide clinicians with a useful assessment tool after surgery.

Although it entails a radiation hazard risk, the use of fluoroscopy during caudal epidural steroid injection has increased to help place the medication more accurately and allowed physicians to maximize the procedure's therapeutic success rate. To investigate the feasibility of using real-time high resolution ultrasonography for guiding the epidural needle into the caudal epidural space and to confirm any vascular intake of medication, we performed color Doppler ultrasonography while medication was being injected into the caudal epidural space of 53 patients with low back pain and sciatica. We defined the injection as being successful if unidirectional flow (observed as one dominant color) of the solution was observed with color Doppler ultrasonography through the epidural space beneath the sacrococcygeal ligament, with no flows being observed in other directions (observed as multiple colors). The correct placement of the medication was then confirmed by fluoroscopy. In 52 of the 53 subjects, the medications were successfully injected into the caudal epidural space with ultrasonography assistance. In fluoroscopy, of these 52 patients, 50 revealed correct placement of the medicine into the epidural space. In conclusion, ultrasonography may be a reliable imaging modality for caudal epidural steroid injection, and its several advantages such as its convenience and the lack of a radiation hazard, make it preferable to fluoroscopy.

No abstract

The cubital tunnel is the most common site of ulnar nerve entrapment. Previous ultrasound studies have demonstrated enlargement of the ulnar nerve in cubital tunnel syndrome but did not report on the cubital tunnel itself. Twenty-two individuals with cubital tunnel syndrome were evaluated with nerve conduction studies and ultrasound. The ultrasound measurement that most strongly correlated with conduction velocity was the ratio of ulnar nerve to cubital tunnel cross-sectional area with the elbow flexed. Measurement of this ratio may improve the diagnostic accuracy of ultrasound in cubital tunnel syndrome, although further investigation is needed.