title: Ultrasound-guided versus Computed Tomography-controlled facet joint injections in the middle and lower cervical spine: a prospective randomized clinical trial.
abstract: OBJECTIVE
  A prospective randomized clinical trial was conducted to evaluate accuracy, time-saving, radiation doses and pain relief of ultrasound-guided (US) facet joint injections versus Computed Tomography (CT)-controlled interventions in the cervical spine.
  
  
  METHODS
  Forty adult patients were consecutively enrolled and randomly assigned to the US- or CT group. US-guided facet joint injections were performed on a standard ultrasound device using a broadband linear-array transducer. The corresponding comparison group underwent CT-guided instillations which were performed under standardized procedures using the CT-positioning laser function.
  
  
  RESULTS
  The accuracy of ultrasound-guided interventions was 100%. The mean time (min:sec) to final needle placement in the US group was 04:46 versus 11:12 (p<0.05) in the CT group for one injected level, and 05:49 in the US group versus 14:32 (p<0.05) in the CT group for two injected levels. The mean dose-length product (DLP, mGy*cm) radiation dose, including CT confirmation for study purposes only, was 27.6 for the US group versus 88.2 in the CT group (p<0.05) for one injected level, and 32.5 in the US group versus 205.0 in the CT group (p<0.05) for two injected levels. Both groups showed the same significant visual-analog-scale (VAS) relief in pain (p<0.05), without any "inter-methodic" differences (p>0.05).
  
  
  CONCLUSIONS
  US-guided intra-articular injections show the same therapeutic effect as CT-guided intra-articular injections and result in a significant reduction of procedure duration without any exposure to radiation.
authors.affiliation: Innsbruck Medical University, Department of Neurosurgery, Anichstrasse 35, 6020 Innsbruck, Austria. jochen.obernauer@i-med.ac.at
authors.forename: Jochen
authors.initials: J
authors.lastname: Obernauer
authors.forename: Klaus
authors.initials: K
authors.lastname: Galiano
authors.forename: Hannes
authors.initials: H
authors.lastname: Gruber
authors.forename: Reto
authors.initials: R
authors.lastname: Bale
authors.forename: Alois Albert
authors.initials: AA
authors.lastname: Obwegeser
authors.forename: Reinhold
authors.initials: R
authors.lastname: Schatzer
authors.forename: Alexander
authors.initials: A
authors.lastname: Loizides
mesh_terms: D001175:Arthrography / Q000379:methods; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000187:drug effects; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000175:diagnosis / Q000188:drug therapy*; D011446:Prospective Studies; D015641:Radiography, Interventional / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods; D021801:Zygapophyseal Joint / Q000000981:diagnostic imaging* / Q000187:drug effects