Ultrasound guidance for epidural steroid injections

Ultrasound Guided Spine Injections: Advancement Over Fluoroscopic Guidance?

“…The acoustic impedance of bone is high, and thus it has significant limitations for imaging spinal structures when the target is obscured by bone tissue. This gives rise to increased risk for accidental dural punctures due to decreased visibility [39]. Given that a higher US image resolution allows for decreased tissue penetration, it will be more difficult to identify neurovascular structures in patients who are more obese.…”

“…Fortyseven of the 53 subjects had a positive flow spectrum and 50 of the 52 subjects with positive Doppler change, had fluoroscopic confirmation. The major limitation of the study was that even small movements of the needle could cause an artifactual color change and a false-positive sign could occur as seen by fluoroscopy in the patients with spread outside of the epidural space [39].…”