| Ultrasound-guided injection of lumbar zygapophyseal joints: an anatomic study with fluoroscopy validation. | |
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MedLine Citation:
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PMID: 22330262 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Diagnostic and therapeutic injections of the zygapophyseal joint (z-joint) are routinely performed under radiologic guidance (eg, fluoroscopy, computed tomography). Technically, these procedures could also be completed using ultrasound guidance, but existing evidence insufficiently supports this alternative imaging method, and it cannot therefore be recommended as a standard practice. There has also been no published proof-of-concept study using a routine fluoroscopy control for ultrasound-guided z-joint injections. METHODS: A cadaver study was performed to validate ultrasound as an imaging modality for z-joint injections. Fifty z-joint injections were performed on 5 nonembalmed specimens. In-plane ultrasound approach was implemented. Zygapophyseal joints were accessed through a needle placement under the joint capsule into the posterior synovial recess. Iohexol was thereby injected, and fluoroscopy was subsequently performed. RESULTS: In 44 (88%) of 50 performed injections, the intra-articular spread of the contrast agent was clearly observed on the fluoroscopy image. In 6 (12%) of 50 cases, the contrast flow appeared in the soft tissues. In 4 of the 6 failed injections, the z-joint gap was not evident on an ultrasound image. No intravascular, nerve root, or epidural injections were observed. CONCLUSIONS: Ultrasound may be a viable alternative to fluoroscopy or computed tomography as a guidance method for lumbar z-joint injections. |
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Authors:
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Michael Gofeld; Sandee J Bristow; Sheila Chiu |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Regional anesthesia and pain medicine Volume: 37 ISSN: 1532-8651 ISO Abbreviation: Reg Anesth Pain Med Publication Date: 2012 Mar-Apr |
Date Detail:
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Created Date: 2012-02-22 Completed Date: 2012-09-21 Revised Date: 2012-12-17 |
Medline Journal Info:
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Nlm Unique ID: 9804508 Medline TA: Reg Anesth Pain Med Country: United States |
Other Details:
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Languages: eng Pagination: 228-31 Citation Subset: IM |
Affiliation:
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Department of Anesthesia and Pain Medicine, University of Washington, Seattle, WA 98195, USA. gofeld@uw.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Female Fluorescent Dyes / administration & dosage* Fluoroscopy / methods Humans Lumbar Vertebrae / ultrasonography* Male Ultrasonography, Interventional / methods* Zygapophyseal Joint / ultrasonography* |
| Chemical | |
Reg. No./Substance:
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0/Fluorescent Dyes |
| Comments/Corrections | |
Comment In:
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Reg Anesth Pain Med. 2012 Jul-Aug;37(4):460; author reply 460-1
[PMID:
22722569
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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