Currently facet joint injections are performed using CT guidance or fluoroscopy.
Our GPS enhanced fusion system allows to combine the precision and panoramic view of these imaging modalities with the US dynamic imaging. The aim of our study was to increase safety,
and efficacy of US-guided facet joint injections using a GPS-driven CT fusion system. This setting may also shorten the time of the procedureand reduce the radiation dose.
Methods and Materials
We evaluated 15 patients (7 males,
mean age 65 years,
range 56-78 years) with a clinical diagnosis of low back pain and previously investigated with CT in order to confirm the presence of facet joints degenerative changes.
All patients received facet joints injection of steroid and anesthetic (2 ml methylprednisolone acetate + 2 ml lignocaine) of the affected levels under US guidance (Logiq E9,
USA) coupled with a GPS-driven fusion system using MR or CT images.
Results: No complications were encountered.
Facet joint injection was performed and in all casesneedle position CT check showed the needle tip into the facet joint or in the periaticular space.
VAS scale significantly decreased from 7.3 ± 2.7 (mean ± SD) at baseline to 3.2 ± 2.7 at 24 weeks (P<0.01).
US needle guidance with CT fusion assistance allows for safe and effective injection of degenerative facet joint disease.
This technique may be readily translated also to other applications in which spinal needles are used.
Our series demonstrates that fusion assisted-US guidance could be easily moved to clinical practice and applicated at patients with a previous diagnostic CT.
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C.Martini Department of Radiology,
Italy. L.M.Sconfienza Department of Radiology,IRCCS Policlinico San Donato – Dipartimento di Scienze Biomediche per la Salute,
Università degli Studi di Milano,
San Donato Milanese,
Italy. E.Silvestri Department of Radiology,
Ospedale Evangelico Internazionale,