Fluoroscopy-Guided Versus Fluoroscopy-Confirmed Ultrasound-Guided S1 Transforaminal Epidural Injection with Pulsed Radiofrequency: A Prospective, Randomized Trial
Eurasian Journal of Medicine, cilt.55, sa.1, ss.43-49, 2023 (ESCI, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 55 Sayı: 1
- Basım Tarihi: 2023
- Doi Numarası: 10.5152/eurasianjmed.2023.22265
- Dergi Adı: Eurasian Journal of Medicine
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, Academic Search Premier, CINAHL, Directory of Open Access Journals, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.43-49
- Anahtar Kelimeler: Interventional ultrasonography, fluoroscopy, epidural injections, pulsed radiofrequency treatment, lower back pain, sacral vertebrae
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: The aim of this prospective randomized controlled study was to compare the effectiveness and accuracy of the ultrasound-and fluoroscopy-guided S1 transforaminal epidural injection combined with pulsed radiofrequency in patients with lumbosacral radicular pain caused by S1 nerve involvement. Materials and Methods: A total of 60 patients were randomized into 2 groups. Patients received S1 trans-foraminal epidural injection combined with pulsed radiofrequency under either ultrasound or fluoroscopy guidance. Primary outcomes were estimated with Visual Analog Scale scores at 6 months. Secondary outcomes included Oswestry Disability Index, Quantitative Analgesic Questionnaire, and patient satisfaction scores during the 6-month follow-up period and procedure-related variables including procedure time and accuracy of the needle replacement. Results: Both techniques provided significant pain reduction and functional improvement for 6 months compared to baseline (P <.001), without statistical significance between groups at each follow-up point. There was no significant difference in pain medication consumption (P =.441) and patient satisfaction scores (P =.673) between groups. The fluoroscopy guidance for combined transforaminal epidural injection with pulsed radiofrequency at S1 provided a greater accuracy for the cannula replacement (100%) than the ultrasound (93.3%), without significant difference between groups (P =.491). Conclusion: The ultrasound-guided combined transforaminal epidural injection with pulsed radiofrequency at S1 level is a feasible alternative to fluoroscopy guidance. In this study, we reported that the ultrasound-guided technique resulted in similar treatment benefits including improvement in pain intensity and function-ality and reduction in pain medication consumption as those in the fluoroscopy group, while reducing the risk for radiation exposure.