title: Ultrasound guided versus CT-controlled pararadicular injections in the lumbar spine: a prospective randomized clinical trial.
abstract: OBJECTIVE
  Injection therapies play a major role in the treatment of lower back pain and are to date performed mainly under CT- or fluoroscopic guidance. We conducted this study to evaluate the accuracy, time savings, radiation doses, and pain relief of US-guided pararadicular injections versus CT-controlled interventions in the lumbar spine in a prospective randomized clinical trial.
  
  
  METHODS
  Forty adult patients were consecutively enrolled and assigned to a US or CT group. US-guided pararadicular injections were performed on a standard US device by using a broadband curved-array transducer (9-4 or 5-1 MHz). In the in-plane technique, the needle was advanced through the respective segmental intertransverse ligament. The needle tip position was verified by CT. The CT-guided approaches were performed under standardized procedures by using the CT-positioning laser function.
  
  
  RESULTS
  The accuracy of US-guided interventions was 90%. The mean time to final needle placement in the US group was 4.0 ± 1.8 minutes, and in the CT group, 7.6 ± 2.1 minutes. The mean radiation doses, including CT confirmation for study purposes only, were 20.3 ± 9.0 mGy cm for the US group and 42.6 ± 36.1 mGy cm for the CT group. Both groups showed the same significant pain relief (P < .05) without relevant "intermethodic" differences of pain relief (P > .05).
  
  
  CONCLUSIONS
  US-guided pararadicular injections show a therapeutic effect similar to that in the time-consuming, expensive, ionizing CT or fluoroscopically guided pararadicular injections and result in a significant reduction of procedure time expenditure and avoidance of radiation.
authors: Department of Radiology, Innstruck Medical University, 6020 Innsbruck, Austria. alexander.loizides@i-med.ac.at
authors: A
authors: A
authors: Loizides
authors: H
authors: H
authors: Gruber
authors: S
authors: S
authors: Peer
authors: K
authors: K
authors: Galiano
authors: R
authors: R
authors: Bale
authors: J
authors: J
authors: Obernauer
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D015552:Injections, Intralesional / Q000379:methods; D007278:Injections, Spinal / Q000379:methods*; D017116:Low Back Pain / Q000000981:diagnostic imaging / Q000188:drug therapy; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D011829:Radiation Dosage; D013126:Spinal Nerve Roots / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014159:Transducers; D018084:Ultrasonography, Interventional / Q000379:methods*