• Jochen Obernauer, Klaus Galiano, Hannes Gruber, Reto Bale, Alois Albert Obwegeser, Reinhold Schatzer, and Alexander Loizides.
• Department of Neurosurgery, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria, jochen.obernauer@uki.at.
• Eur Spine J. 2013 Nov 1;22(11):2532-7.

PurposeWe conducted this study to evaluate accuracy, time saving, radiation doses, safety, and pain relief of ultrasound (US)-guided periradicular injections versus computed tomography (CT)-controlled interventions in the cervical spine in a prospective randomized clinical trial.MethodsForty adult patients were consecutively enrolled and randomly assigned to either a US or a CT group. US-guided periradicular injections were performed on a standard ultrasound device using a broadband linear array transducer. By basically following the osseous landmarks for level definition in "in-plane techniques", a spinal needle was advanced as near as possible to the intended, US-depicted nerve root. The respective needle tip positioning was then verified by CT. The control group underwent CT-guided injections, which were performed under standardized procedures using the CT-positioning laser function.ResultsThe accuracy of US-guided interventions was 100%. The mean time to final needle placement in the US group was 02:21 ± 01:43 min:s versus 10:33 ± 02:30 min:s in the CT group. The mean dose-length product radiation dose, including CT confirmation for study purposes only, was 25.1 ± 16.8 mGy cm for the US group and 132.5 ± 78.4 mGy cm for the CT group. Both groups showed the same significant visual analog scale decay (p < 0.05) without "inter-methodic" differences of pain relief (p > 0.05).ConclusionsUS-guided periradicular injections are accurate, result in a significant reduction of procedure expenditure under the avoidance of radiation and show the same therapeutic effect as CT-guided periradicular injections.

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