一项评估超声引导下骶髂关节注射准确性的尸体研究。

A Cadaveric Study Assessing the Accuracy of Ultrasound-Guided Sacroiliac Joint Injections.

作者信息

Perry Jason M, Colberg Ricardo E, Dault Stacey L, Beason David P, Tresgallo Ruben A

机构信息

Andrews Sports Medicine and Orthopedic Center, Birmingham, AL(∗).

Andrews Sports Medicine and Orthopedic Center, 805 St Vincent's Drive, Suite 100, Birmingham, AL 35205(†).

出版信息

PM R. 2016 Dec;8(12):1168-1172. doi: 10.1016/j.pmrj.2016.05.002. Epub 2016 May 10.

DOI:10.1016/j.pmrj.2016.05.002

PMID:27178376

Abstract

BACKGROUND

Ultrasound guidance has been proposed as an alternative imaging modality for sacroiliac (SI) joint injections. Few studies have been published on the accuracy of this modality for the procedure.

OBJECTIVE

The objective of this study was to determine the accuracy of ultrasound-guided SI joint injections using a cadaveric model.

DESIGN

Controlled laboratory study.

SETTING

The study was performed in the Skills Laboratory of the American Sports Medicine Institute in St. Vincent's Hospital, Birmingham, AL.

METHODS

Seventeen cadaveric SI joints were injected under ultrasound guidance and dissected to determine the accuracy of intra-articular injections.

MAIN OUTCOME MEASUREMENTS

The presence of intra-articular spread of a white paint marker in the SI joint after ultrasound-guided injection.

RESULTS

Of 17 SI joints, 15 (88.2%) were accurately injected intra-articularly. One of the joints with no intra-articular spread was found to be partially frozen at the time of dissection, and the second joint was considered an unsuccessful injection before dissection due to difficulty entering the joint under ultrasound guidance because of marginal osteophytes at the joint line. Of the 15 joints with intra-articular placement, 5 joints (33.3%) showed partial extra-articular spread at the time of initial injection and required redirection of the needle under ultrasound guidance, and 3 joints (20%) had extra-articular spread that was not seen during ultrasound.

CONCLUSION

Ultrasound allowed intra-articular injection in 88.2% of joints in this cadaveric study. Ultrasound does not expose the patient to radiation, as seen with fluoroscopic guidance, which is currently the gold standard for this injection. In addition, ultrasound may allow visualization of extra-articular spread when caused by extra-articular needle placement, which can allow for redirection of the needle to achieve intra-articular injection.

LEVEL OF EVIDENCE

IV.

摘要

背景

超声引导已被提议作为骶髂关节注射的一种替代成像方式。关于这种方式在该操作中的准确性，发表的研究很少。

目的

本研究的目的是使用尸体模型确定超声引导下骶髂关节注射的准确性。

设计

对照实验室研究。

地点

该研究在美国阿拉巴马州伯明翰市圣文森特医院的美国运动医学研究所技能实验室进行。

方法

在超声引导下对17个尸体骶髂关节进行注射，然后解剖以确定关节内注射的准确性。

主要观察指标

超声引导注射后，骶髂关节内白色油漆标记物的关节内扩散情况。

结果

17个骶髂关节中，15个（88.2%）被准确注射到关节内。其中一个没有关节内扩散的关节在解剖时发现部分冻结，另一个关节在解剖前被认为注射不成功，因为在超声引导下由于关节线处的边缘骨赘难以进入关节。在15个关节内注射的关节中，5个关节（33.3%）在初次注射时显示部分关节外扩散，需要在超声引导下重新调整针头方向，3个关节（20%）有超声检查时未发现的关节外扩散。