Ultrasound guided chronic pain interventions (Part I)

Akkaya, Taylan; Alptekin, Alp; Özkan, Derya

doi:10.5505/agri.2015.27879

Cited by 2 publications

(2 citation statements)

References 59 publications

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“…fluoroscopy- or US-guided CESI [ 4 , 10 , 14 , 18 , 23 , 30 ]. Each of these studies reported different results on the advantages or disadvantages of each technique in terms of technical considerations, complications, and financial aspects [ 4 , 5 , 31 – 34 ]. The discrepancies between these studies might be attributed to methodological heterogeneities [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of ultrasonography-guided caudal epidural steroid injection compared to the fluoroscopic application

Kesılmez¹,

Yüksel²,

Bozan³

et al. 2023

Turkish Journal of Medical Sciences

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Background/aim Caudal epidural steroid injection (CESI) has been increasingly used for treating lower back pain. However, there is still significant controversy about the efficacy and safety of different imaging techniques used to guide CESI. In this context, the objective of this study is to compare the efficacies of fluoroscopy- and ultrasonography-guided CESI in patients with chronic lower back pain. Materials and methods The population of this retrospective, observational study consisted of all consecutive patients who underwent CESI for lower back pain between 2018 and 2020. Of the 371 patients included in the study sample, 192 had undergone fluoroscopy-guided CESI (Group F) and 179 ultrasonography-guided CESI (Group U). Patients’ pain and functional statuses were evaluated using the visual analog scale (VAS) and Oswestry Disability Index (ODI) immediately before (baseline) and after the procedure (postintervention day 0-D0), during the second week (D15), the first month (D30), and the third month (D90) after the procedure. Results The mean age of Group F was significantly higher than that of Group U (p < 0.001). The number of patients with lumbar disc hernia was significantly higher in Group U, whereas the number of patients with spinal stenosis and lumbar disc hernia + spinal/lumbar stenosis was significantly higher in Group F (p = 0.001). The baseline and D0 ODI scores were significantly lower in Group U than in Group F (p = 0.006 and p = 0.017, respectively). There was no significant difference between the groups in other VAS and ODI scores (p > 0.05). Intragroup analyses revealed significant reductions in VAS and ODI scores over the follow-up period till D30 compared to the baseline scores in each group (p < 0.001). The decrease recorded in the ODI score between the D15 and baseline measurements was significantly higher in Group F than in Group U (p = 0.006). Conclusion The study findings indicated that ultrasound-guided CESI was as effective as fluoroscopy-guided CESI in treating chronic lower back pain.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of ultrasonography-guided caudal epidural steroid injection compared to the fluoroscopic application

Kesılmez¹,

Yüksel²,

Bozan³

et al. 2023

Turkish Journal of Medical Sciences

View full text Add to dashboard Cite

show abstract

“…However, conventional RF is routinely guided by X-rays, so it may increase the risk of radiation exposure to the patients and health care providers [ 12 ]. Thus, musculoskeletal ultrasonography has become a potential guidance method for RF instead of fluoroscopy in chronic pain management due to its unique advantages [ 13 , 14 ]. For example, ultrasound guidance is very accurate in peripheral or paraspinal nerve blocks to avoid injury of blood vessels and pleura [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Ultrasound-Guided Radiofrequency Treatment for Chronic Pain in Patients with Knee Osteoarthritis: A Systematic Review and Meta-Analysis

Huang

Deng

Yang

et al. 2020

Pain Research and Management

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Background. Knee osteoarthritis (KOA) is a common degenerative disease associated with joint dysfunction and pain. Ultrasound-guided radiofrequency (RF) may be a promising therapy in the treatment of chronic pain for KOA patients. Objective. To evaluate the efficacy and safety of ultrasound-guided RF treatment for chronic pain in patients with KOA. Design. A systematic review was conducted, and a meta-analysis was carried out when possible. Setting. We examined the studies evaluating the clinical efficiency of ultrasound-guided RF on chronic pain in KOA population. Method. A systematic review for the efficacy and safety of ultrasound-guided RF treatment for pain management of KOA patients was carried out in PubMed, EMBASE, Cochrane Library, Web of Science, Wanfang Data, and China National Knowledge Infrastructure (CNKI) from the date of inception to February 2020, and a meta-analysis was conducted. The primary outcomes of pain intensity (visual analogue scale or numerical rating scale) and knee function [the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)] were evaluated from baseline to various follow-up times by random-effects model. Heterogeneity was assessed by I2 statistic and the potential sources of heterogeneity by subgroup and metaregression analyses, respectively. Results. Eight publications with 256 patients were included in the meta-analysis. RF could relieve pain with −4.196 of pooled mean difference and improve knee function by decreasing 23.155 points in WOMAC. Three patients had ecchymosis, two with hypoesthesia and one with numbness after the procedure, and improved within 6 months. Furthermore, study design and treatment target were the sources of heterogeneity by subgroup and metaregression analyses, accounting for 37% and 74% of variances, respectively. Target of genicular nerve achieved better pain relief than intra-articular or sciatic nerve. Sensitivity analysis showed that removal of any single study was unlikely to overturn the findings. Limitations. There were some limitations in the study. Firstly, the small number of relevant studies limited the confidence level of the meta-analysis. Also, the significant heterogeneity may not be explained due to the limited data. Secondly, the direct comparison of two different guidance methods (ultrasound vs. fluoroscopy) for RF therapy is lacking. In addition, the outcomes were blindly assessed in the meta-analysis from all studies according to evaluation of bias, which could affect the reality of the data. Finally, most of the studies only provided short follow-up times, so we could not analyze the long-term effectiveness of ultrasound-guided RF in the treatment of patients with KOA. Conclusions. Ultrasonography is an effective, safe, nonradiative, and easily applicable guidance method for RF in pain relief and functional improvement in KOA patients.

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Ultrasound guided chronic pain interventions (Part I)

Cited by 2 publications

References 59 publications

Effectiveness of ultrasonography-guided caudal epidural steroid injection compared to the fluoroscopic application

Effectiveness of ultrasonography-guided caudal epidural steroid injection compared to the fluoroscopic application

Efficacy and Safety of Ultrasound-Guided Radiofrequency Treatment for Chronic Pain in Patients with Knee Osteoarthritis: A Systematic Review and Meta-Analysis

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