Viderman Dmitriy, Aubakirova Mina, Aryngazin Anuar, Yessimova Dinara, Kaldybayev Dastan, Tankacheyev Ramil, Abdildin Yerkin G
Department of Surgery, Section of Anesthesiology, Intensive Care, and Pain Medicine, Nazarbayev University School of Medicine (NUSOM), Astana 020000, Kazakhstan.
Department of Mechanical and Aerospace Engineering, School of Engineering and Digital Sciences, Nazarbayev University, Astana 010000, Kazakhstan.
Diagnostics (Basel). 2023 Nov 18;13(22):3474. doi: 10.3390/diagnostics13223474.
The objective of this study was to compare the outcomes of the ultrasound- and fluoroscopy-guided techniques in the management of back pain. Using PubMed, Scopus, and the Cochrane Library, we searched randomized controlled trials (RCTs) published before May 2023, which reported relevant data on the topic. The effectiveness of the ultrasound-guided (US-guided) and fluoroscopy-guided (FL-guided) approaches for back pain management was compared in terms of postoperative pain intensity, postoperative functional outcomes, and postoperative complications. Subgroup analyses were conducted for different postoperative periods. Eight studies were included in the analysis. There was no significant difference in post-procedural pain relief at one week, two weeks, one month, two months, and three months between the US-guided and FL-guided interventions for back pain management (SMD with 95% CI is -0.01 [-0.11, 0.10]), = 0.91, I = 0%). In terms of the postoperative functional outcomes assessed by the "Oswestry Disability Index" (ODI) functionality score, the model tends to favor the FL-guided injections over the US-guided injections (SMD with 95% CI: 0.13 [-0.00, 0.25], = 0.05, I = 0). Finally, the US-guided and FL-guided injections did not show significantly different results in terms of postoperative complications (RR with 95% CI is 0.99 [0.49, 1.99], = 0.97, I = 0). The subgroup analysis also did not demonstrate differences between the US-guided and FL-guided techniques in the following outcomes: vasovagal reaction, transient headache, and facial flushing. There was no significant difference between the US-guided and FL-guided injections for treating back pain in terms of postoperative pain intensity and complications. Still, the model tends to favor the FL-guided injections over the US-guided injections in terms of functionality.
本研究的目的是比较超声引导和荧光透视引导技术在背痛管理中的效果。我们使用PubMed、Scopus和Cochrane图书馆，检索了2023年5月之前发表的随机对照试验（RCT），这些试验报告了该主题的相关数据。从术后疼痛强度、术后功能结果和术后并发症方面比较了超声引导（US引导）和荧光透视引导（FL引导）方法在背痛管理中的有效性。对不同的术后时期进行了亚组分析。八项研究纳入了分析。在背痛管理的US引导和FL引导干预之间，术后1周、2周、1个月、2个月和3个月的程序后疼痛缓解没有显著差异（SMD，95%CI为-0.01[-0.11,0.10]），P = 0.91，I² = 0%）。根据“奥斯威斯利残疾指数”（ODI）功能评分评估的术后功能结果，模型倾向于FL引导注射优于US引导注射（SMD，95%CI：0.13[-0.00,0.25]），P = 0.05，I² = 0）。最后，US引导和FL引导注射在术后并发症方面没有显示出显著差异（RR，95%CI为0.99[0.49,1.99]），P = 0.97，I² = 0）。亚组分析也未显示US引导和FL引导技术在以下结果上存在差异：血管迷走神经反应、短暂性头痛和面部潮红。在术后疼痛强度和并发症方面，US引导和FL引导注射治疗背痛没有显著差异。然而，在功能方面，模型倾向于FL引导注射优于US引导注射。
