title: Effectiveness of Ultrasound-Guided Versus Fluoroscopy or Computed Tomography Scanning Guidance in Lumbar Facet Joint Injections in Adults With Facet Joint Syndrome: A Meta-Analysis of Controlled Trials.
abstract: To review the literature and assess the comparative effectiveness of ultrasound-guided (USG) versus computed tomography (CT)-/fluoroscopy-guided lumbar facet joint injections in adults.
  
  
  
  PubMed, Ovid MEDLINE, Ovid Embase, EBSCO, and Web of Science.
  
  
  
  Randomized or nonrandomized controlled trials comparing the clinical effectiveness between USG and CT-/fluoroscopy-guided injection techniques in patients with facet syndrome were included.
  
  
  
  Two reviewers independently screened abstracts and full texts. The results of the mean procedure duration, decreased pain score, and Modified Oswestry Disability score after treatment were extracted and presented in the form of mean ± SD.
  
  
  
  There were 103 records screened; 3 studies were included, with a total of 202 adults with facet joint pain. There was no statistically significant difference between the 2 groups in pain score and Modified Oswestry Disability score after injection (weighted mean difference [WMD], .07; 95% confidence interval [CI], -.51 to .65; P=.80; I(2)=78%; WMD, -.55; 95% CI, -1.31 to .22; P=.16; I(2)=0%, respectively). There was also no statistically significant difference in the mean procedure duration between the 2 groups (standardized mean difference [SMD], .97; 95% CI, -1.01 to 2.94; P=.34; I(2)=97%).
  
  
  
  This review suggested that no significant differences in pain and functional improvement were noted between the USG and CT-/fluoroscopy-guided techniques in facet joint injection. USG injection is feasible and minimizes exposure of radiation to patients and practitioners in the lumbar facet joint injection process.
authors.affiliation: Department of Rehabilitation Medicine, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Zhe Jiang, PR China.
authors.forename: Tao
authors.initials: T
authors.lastname: Wu
authors.affiliation: Department of Rehabilitation Medicine, First Hospital of Shi Zui Shan, Ning Xia Medical University, Ning Xia Hui Autonomous Region, PR China.
authors.forename: Wei-Hua
authors.initials: WH
authors.lastname: Zhao
authors.affiliation: Department of Rehabilitation Medicine, Hangzhou Hospital of Zhejiang Chinese People's Armed Police Force, Zhe Jiang, PR China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Dong
authors.affiliation: Department of Rehabilitation Medicine, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Zhe Jiang, PR China.
authors.forename: Hai-Xin
authors.initials: HX
authors.lastname: Song
authors.affiliation: Department of Rehabilitation Medicine, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Zhe Jiang, PR China. Electronic address: zjdxsyfkfk@126.com.
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Li
mesh_terms: D005471:Fluoroscopy; D006801:Humans; D007270:Injections, Intra-Articular / Q000379:methods*; D017116:Low Back Pain / Q000188:drug therapy*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D015641:Radiography, Interventional / Q000379:methods; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional / Q000379:methods; D021801:Zygapophyseal Joint / Q000000981:diagnostic imaging*