The Efficacy of Selective Nerve Root Injection Guided by Ultrasound or Fluoroscopy in Patients with Chronic Low Back Pain and Unilateral Radiculopathy

Mei Zhang1*, Zhonghuang Xu2, Zhiyou Peng3, Bolun Su4 and Yizhun Zhu1

1State Key Laboratory of Quality Research in Chinese Medicine, School of Pharmacy, Macau University of Science and Technology, China 2Department of Pain Medicine, Arion Cancer Center, China 3Department of Pain Medicine, The First Affiliated Hospital, College of Medicine, Zhejiang University, China 4School of Medicine, Macau University of Science and Technology, China

^*Correspondance to: Mei Zhang 

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Abstract:

Purpose: The purpose of this study is to evaluate the efficacy of ultrasound-guided or fluoroscopyguided selective nerve root injection in patients with chronic low back pain and unilateral radiculopathy (caused by Lumbar Disc Herniation or Spinal Stenosis, shorthand for LDH or SST). Methods: 79 patients with chronic low back pain combined with radiculopathy were selected and divided into ultrasound group and fluoroscopy group. Local anesthesia and steroid infiltration were performed with ultrasound guidance or fluoroscopy guidance respectively around the marked nerve roots. We observed the time it took for the needle to reach the target nerve root during treatment. Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were collected before operation and one, two and three months after operation. Results: Needle placement takes 220.3 ± 8.9 s in the ultrasound group, and it takes 445.8 ± 27.2 s in the fluoroscopy group. VAS scores and ODI (clinical improvement) were significantly decreased at each time point. Conclusion: Selective nerve root injection under the guidance of both techniques showed significant clinical efficacy (VAS score and ODI decreased). Ultrasound guidance is a safe alternative that can greatly reduce the time it takes for the needle to reach the target nerve root. However, there is little difference in the effect between the two guidance methods. As far as clinical practicality is concerned, ultrasound is still superior to fluoroscopic guidance for its convenience and non-radiation.

Keywords:

Disability assessment; Fluoroscopy; Ultrasound; Lumbar nerve root

Cite the Article:

Zhang M, Xu Z, Peng Z, Su B, Zhu Y. The Efficacy of Selective Nerve Root Injection Guided by Ultrasound or Fluoroscopy in Patients with Chronic Low Back Pain and Unilateral Radiculopathy. Ann Clin Case Rep. 2022; 7: 2128..