Senkal Serkan, Sir Ender
University of Health Sciences, Gulhane Medical Faculty, Department of Anesthesiology and Reanimation, Ankara, Turkey.
Turk Neurosurg. 2021;31(1):119-123. doi: 10.5137/1019-5149.JTN.31515-20.2.
To compare the efficacies of fluoroscopy- and ultrasound (US)-guided caudal epidural steroid injections (CESIs) in patients with chronic low back pain (LBP).
This study included patients with chronic LBP who underwent US- (Group U; n = 90) or fluoroscopyguided (Group F; n = 90) CESI. The procedure time, successful injection rate on the first attempt, complication rate, Oswestry Disability Index (ODI) score, and Numeric Rating Scale (NRS) score before CESI and after 3 weeks and 3 months of CESI were analyzed.
NRS and ODI scores improved at 3 weeks (p < 0.001) and 3 months (p < 0.001) after CESIs. No significant differences were noted between the two groups for the NRS (p=0.22 and p=0.47) and ODI (p=0.58, p=0.22) scores. Moreover, the CESI procedure time was significantly shorter (p < 0.001) and the successful injection rate on the first attempt was significantly higher (p=0.002) in Group U than in Group F. The complication rate difference was statistically insignificant between the two groups (p > 0.05).
Outcomes of US-guided CESI were superior than those of fluoroscopy-guided CESI considering the successful injection rate on the first attempt and procedure time. In addition, US-guided CESI was as effective as fluoroscopy-guided CESI and did not expose patients and practitioners to radiation.
比较荧光透视引导和超声引导下的骶管硬膜外类固醇注射(CESI)对慢性下腰痛(LBP)患者的疗效。
本研究纳入了接受超声引导(U组;n = 90)或荧光透视引导(F组;n = 90)CESI的慢性LBP患者。分析了操作时间、首次注射成功率、并发症发生率、Oswestry功能障碍指数(ODI)评分以及CESI前、CESI后3周和3个月时的数字评分量表(NRS)评分。
CESI后3周(p < 0.001)和3个月(p < 0.001)时,NRS和ODI评分改善。两组的NRS评分(p = 0.22和p = 0.47)和ODI评分(p = 0.58,p = 0.22)无显著差异。此外,U组的CESI操作时间明显更短(p < 0.001),首次注射成功率明显更高(p = 0.002),高于F组。两组并发症发生率差异无统计学意义(p > 0.05)。
考虑到首次注射成功率和操作时间,超声引导下的CESI效果优于荧光透视引导下的CESI。此外,超声引导下的CESI与荧光透视引导下的CESI效果相同,且不会使患者和操作者暴露于辐射中。