title: Ultrasound-guided Versus Fluoroscopy-controlled Lumbar Transforaminal Epidural Injections: A Prospective Randomized Clinical Trial.
abstract: OBJECTIVE
  Recently, most lumbar spine injections have been administered under ultrasound (US) guidance; however, there is no standard method for US-guided lumbar transforaminal epidural injection (TFEI). In this study, we evaluated the accuracy, effect on pain relief, and safety of US-guided lumbar TFEI.
  
  
  METHODS
  A total of 80 patients with low back pain and radicular pain were enrolled. The patients were randomly assigned to either the fluoroscopy (FL) group or the US group. The FL-guided approaches were performed under standardized procedures using the C-arm, whereas the US-guided injections were performed with an US device with a linear probe, and were verified by FL. The needle tip reached the lateral side of the lamina in the axis view and the middle of the adjacent facet joints in the parasagittal view. Afterward, the needle was advanced slightly deeper until the loss-of-resistance test was positive.
  
  
  RESULTS
  The success ratio of the US-guided interventions was 85%. The operation time in the US group (518±103 s) was shorter than the FL group (929±228 s) (P<0.05). In addition, the radiation dosage in the US group (2640±906 μGy m²) was lower than in the FL group (8992±2132 μGy m²). There was no significant difference in pain relief between the US and FL groups. No serious complication was observed in any of the patients in either group.
  
  
  CONCLUSIONS
  Lumbar TFEI under US guidance was feasible, safe, and required less radiation to achieve the same benefit as the FL-guided interventions.
authors: *Department of Anesthesiology, The Fourth Affiliated Hospital, Harbin Medical University Departments of †Anesthesiology §Dermatology, The Second Affiliated Hospital, Harbin Medical University, Harbin, China ‡The Hei Long Jiang Province Key Lab of Research on Anesthesiology and Critical Care Medicine, Harbin, China.
authors: Ge
authors: G
authors: Yang
authors: Jinfeng
authors: J
authors: Liu
authors: Liangjuan
authors: L
authors: Ma
authors: Zhenhua
authors: Z
authors: Cai
authors: Chao
authors: C
authors: Meng
authors: Sihua
authors: S
authors: Qi
authors: Huacheng
authors: H
authors: Zhou
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage*; D005260:Female; D005471:Fluoroscopy / Q000592:standards; D017408:Guidelines as Topic / Q000592:standards; D006801:Humans; D007268:Injections, Epidural; D017116:Low Back Pain / Q000000981:diagnostic imaging / Q000188:drug therapy; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D011843:Radiculopathy / Q000000981:diagnostic imaging / Q000188:drug therapy; D018084:Ultrasonography, Interventional / Q000592:standards; D055815:Young Adult
chemical_list: D000700:Analgesics