European radiology
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Comparative Study
Ultrasound- versus fluoroscopy-guided injections in the lower back for the management of pain: a systematic review.
Ultrasound-guided spinal injections are less common than fluoroscopy-guided injections. Although unable to penetrate bones, ultrasound guidance has a number of advantages including convenience and reduced exposure to ionizing radiation. However, it is not known how ultrasound-guided injections compare to fluoroscopy-guided injections in the management of lower back pain. Our objective is to systematically review the literature comparing ultrasound-guided injections to fluoroscopy-guided injections for the management of lower back pain. ⋯ • There were no differences in pain relief, procedure time, number of needle passes, changes in disability indices, complications or adverse events, post-procedure opioid consumption, or patient satisfaction between ultrasound- and fluoroscopy-guided injections for the management of lower back pain. • Given the lack of evidence to demonstrate superior efficacy and the added harms with fluoroscopic guidance, ultrasound guidance may be the preferred method of guidance for injections to manage lower back pain in appropriate patients. Further study is required to understand the exact role of ultrasound in image-guided injections.