Comparison of Ultrasonography- and Fluoroscopy-Guided Facet Joint Block in the Lumbar Spine

Abstract

Study DesignRetrospective study.PurposeFacet joint block is performed for diagnostic or therapeutic purposes and generally carried out under computerd tomography (CT) or radiologic fluoroscopy guidance. Ultrasonography-guided facet block has recently been attempted. So, we compared the results of ultrasonography-guided facet joint block with the results of fluoroscopy-guided facet joint block.Overview of LiteratureBecause fluoroscopic or CT guided facet joint block has been reported side effects, we performed spinal facet block using a fluoroscopy-guided method.MethodsWe selected 133 patients who had lumbar pain or referred pain. They were diagnosed as having spinal stenosis and hospitalized from January 2008 to June 2008. As the subjects, we selected 105 patients who had been follow-up for more than 6 months and carried out a prospective study.Twenty six subjects were male and 25 were female in the fluoroscopy group (group 1) and their mean age was 56.1 years (range, 45 to 79 years). Twenty one were male and 33 were female in the ultrasonography-guided group (group 2). Their mean age was 58.3 years (range, 47 to 83 years). We studied the average time of the procedures, complications, the difference of the therapeutic cost between the two groups. We also evaluated the visual analogue scale (VAS) score and the Oswestry disability index.ResultsThe procedure in group 2 averaged 4 minutes and 25 seconds, and in group 1, 4 minutes and 7 seconds. The coast was an average of 38,000 won in group 2 and 25,000 won in group 1. The VAS score was improved from an average of 7.5 (range, 5 to 9) to 2.8 (range, 2 to 6) in group 2 and from 7.8 (range, 4 to 10) to 2.7 (range, 2 to 5) in group 1. The Oswestry disability index was improved from an average of 32.3 (range, 28 to 41) to 23.5 (range, 17 to 26) in group 2 and from 34.2 (range, 29 to 43) to 24.8 (range, 18 to 28) in group 1. As for complications, worsening of lumbar pain, paresthesia, headache and allergic reaction were detected in 5 cases of group 2 and in 3 of group 1. Those symptoms were improved within several hours. One case of superficial infection that developed in group 2 was improved within several days.ConclusionsWe should consider that ultrasonography-guided facet joint block is a minimal invasive procedure that is easily carried out without radiation exposure.

Spinal Needle Navigation by Tracked Ultrasound Snapshots

“…It has been found in a single-center comparative study that US-guided facet joint injections produce skin infections more often than the fluoroscopy-guided alternative [19]. Tracked US snapshot guidance has an advantage that skin disinfection can be applied around the needle entry point between the time of US snapshot and the needle insertion.…”

Nonspecific low back pain: Causes, clinical picture, diagnosis, and treatment

“…Эффективность ГК в лечении фасеточного синдрома была показана в РКИ, при этом внутрисуставное введение оказалось эффективнее си-стемного применения [71]. Проведение блокад под контро-лем ультразвука оказалось столь же эффективным, как и при использовании рентгенологического контроля, и зна-чительно более безопасным в отношении радиационной на-грузки [72]. В то же время имеются данные о неэффектив-ности блокад при фасеточном синдроме.…”

Sonographically Guided Lumbar Spine Procedures

“…The sonographically guided intra‐articular facet injection approach was also compared to the most commonly used fluoroscopically guided approach in a retrospective study 33 . In both groups, the intra‐articular injections improved pain control, and there were no significant differences in the incidence of complications between the two guidance methods.…”