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Cooper C, Fisher R, Eghrari N, Chen M, Kulhari S, Hosseini M, Kim C. Basic radiation safety practices: observed radiation doses in a phantom model. PAIN MEDICINE (MALDEN, MASS.) 2024; 25:584-586. [PMID: 38718178 DOI: 10.1093/pm/pnae039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 04/24/2024] [Accepted: 05/02/2024] [Indexed: 09/04/2024]
Affiliation(s)
- Claire Cooper
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States
| | - Ryan Fisher
- MetroHealth/Case Western Reserve University School of Medicine, Cleveland, OH 44109, United States
| | - Nafis Eghrari
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States
| | - Matthew Chen
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States
| | - Sajal Kulhari
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States
| | - Maryam Hosseini
- MetroHealth/Case Western Reserve University School of Medicine, Cleveland, OH 44109, United States
| | - Chong Kim
- MetroHealth/Case Western Reserve University School of Medicine, Cleveland, OH 44109, United States
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Omar S, Hegab SES, Reda MIS, El-Karadawy SA, Saad MM, El Sekily NM, Elaassar OS. Ultrasound-guided fluoroscopic-verified trans-foraminal lumbar dorsal root ganglion pulsed radiofrequency modulation for radicular pain relief: clinical and cadaveric evaluation of the technique. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2021. [DOI: 10.1186/s43055-021-00416-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Ultrasound-guided lumbar pain interventions were thought to be difficult; the high acoustic impedance of bone hides the underling structures and needle path. Reviewing the sonoanatomy of the lumbar region using different planes and angles made better sonographic guidance for spine injections. The aim of this prospective study is to assess the accuracy and safety of ultrasound (US)-guided lumbar trans-foraminal pulsed radiofrequency of the dorsal root ganglion confirmed by fluoroscopic imaging in management of chronic radicular pain.
Results
Thirty-two patients, with 34 lumbar interventions, were included in the study. Thirty-one interventions out of 34 were performed successfully with overall accuracy of 91.18% and with minimal complications. The successful first trial placement of the cannula was calculated in 44.1% of interventions; multiple trials were needed in 47.1% while incorrect level was encountered in 8.8%. Visual analogue scale of pain and Oswestry Disability Index decreased significantly after intervention up to 3 months compared to the pre-intervention value. The analgesic consumption was reduced by mean of 73.44 ± 31.07% 1 month after intervention.
Conclusions
US-guided fluoroscopic-verified trans-foraminal PR of lumbar DRG is accurate, safe, and effective for CRP.
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Tay M, Sian SCSH, Eow CZ, Ho KLK, Ong JH, Sirisena D. Ultrasound-Guided Lumbar Spine Injection for Axial and Radicular Pain: A Single Institution Early Experience. Asian Spine J 2021; 15:216-223. [PMID: 32872762 PMCID: PMC8055452 DOI: 10.31616/asj.2019.0399] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 03/07/2020] [Accepted: 03/15/2020] [Indexed: 12/24/2022] Open
Abstract
STUDY DESIGN Clinical audit via retrospective review of a database. PURPOSE To report an early experience using ultrasound-guided lumbar spinal injection for axial and radicular pain in an Asian multiethnic cohort. OVERVIEW OF LITERATURE Ultrasound-guided spine injection therapy is a comparatively new technique in the management of axial and radicular pain from degenerative lumbar spinal conditions, which may be a reasonable alternative to conventional fluoroscopic or computed tomography-guided injection. METHODS A retrospective review was conducted, involving all patients who underwent ultrasound-guided lumbar spine injection therapy at a single institution over 1 year. Patients were evaluated by two interventionists, who then performed standardized ultrasound-guided lumbar facet joint and pararadicular spinal injections. RESULTS There were 42 patients treated at our Sports Medicine Centre; with 27 patients (64.3%) receiving facet joint injections and 18 patients (42.9%) receiving nerve root injections. The majority (90.5%) of patients experienced an improvement of >30% in pain intensity at 3 months post-injection, using the Numerical Rating Scale pain score (p<0.001); with 40 patients (95.2%) reporting a reduction in Oswestry Disability Index score (p<0.001). No complications were reported. CONCLUSIONS Our initial experience confirms the safety, feasibility, and effectiveness of ultrasound-guided lumbar spinal injection for the treatment of axial and radicular pain in an Asian multiethnic cohort.
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Affiliation(s)
- Matthew Tay
- Sports Medicine Centre, Khoo Teck Puat Hospital, Singapore
- Department of Rehabilitation Medicine, Tan Tock Seng Hospital Rehabilitation Centre, Singapore
| | | | - Chen Zhi Eow
- Yong Loo Lin Medical School, National University of Singapore, Singapore
| | - Kelvin Lor Kah Ho
- Department of Orthopaedic Surgery, Khoo Teck Puat Hospital, Singapore
| | - Joo Haw Ong
- Sports Medicine Centre, Khoo Teck Puat Hospital, Singapore
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Accuracy of the Anatomic Placement in Ultrasonography Guided Facet Joint Blockage with Supervising of C-Arm Fluoroscopy. IRANIAN JOURNAL OF RADIOLOGY 2019. [DOI: 10.5812/iranjradiol.84389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Ultrasound- versus fluoroscopy-guided injections in the lower back for the management of pain: a systematic review. Eur Radiol 2019; 29:3401-3409. [PMID: 30887198 DOI: 10.1007/s00330-019-06065-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 01/10/2019] [Accepted: 02/04/2019] [Indexed: 01/02/2023]
Abstract
PURPOSE Ultrasound-guided spinal injections are less common than fluoroscopy-guided injections. Although unable to penetrate bones, ultrasound guidance has a number of advantages including convenience and reduced exposure to ionizing radiation. However, it is not known how ultrasound-guided injections compare to fluoroscopy-guided injections in the management of lower back pain. Our objective is to systematically review the literature comparing ultrasound-guided injections to fluoroscopy-guided injections for the management of lower back pain. METHODS Medline, Cochrane CENTRAL Register of Controlled Trials, Embase, and NHSEED were searched from 2007 to September 26, 2017. Inclusion criteria included (1) randomized controlled trial design, (2) compared ultrasound-guided and fluoroscopy-guided injections for lower back pain, (3) dose and volume of medications injected were identical between trial arms, and (4) reported original data. RESULTS One hundred one unique records were identified, and 21 studies were considered for full-text inclusion. Nine studies formed the final data set. Studies comparing ultrasound- and fluoroscopy-guided injections for lower back pain management reported no difference in pain relief, procedure time, number of needle passes, changes in disability indices, complications or adverse events, post-procedure opioid consumption, or patient satisfaction. CONCLUSION Fluoroscopic guidance of injections for the management of lower back pain is similar in efficacy to ultrasound guidance. The exact role of ultrasound guidance needs to be further studied, especially for nerve root injections, where safety is the major concern. KEY POINTS • There were no differences in pain relief, procedure time, number of needle passes, changes in disability indices, complications or adverse events, post-procedure opioid consumption, or patient satisfaction between ultrasound- and fluoroscopy-guided injections for the management of lower back pain. • Given the lack of evidence to demonstrate superior efficacy and the added harms with fluoroscopic guidance, ultrasound guidance may be the preferred method of guidance for injections to manage lower back pain in appropriate patients. Further study is required to understand the exact role of ultrasound in image-guided injections.
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Robotic ultrasound-guided facet joint insertion. Int J Comput Assist Radiol Surg 2018; 13:895-904. [DOI: 10.1007/s11548-018-1759-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Accepted: 03/27/2018] [Indexed: 02/07/2023]
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Pesteie M, Lessoway V, Abolmaesumi P, Rohling RN. Automatic Localization of the Needle Target for Ultrasound-Guided Epidural Injections. IEEE TRANSACTIONS ON MEDICAL IMAGING 2018; 37:81-92. [PMID: 28809679 DOI: 10.1109/tmi.2017.2739110] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Accurate identification of the needle target is crucial for effective epidural anesthesia. Currently, epidural needle placement is administered by a manual technique, relying on the sense of feel, which has a significant failure rate. Moreover, misleading the needle may lead to inadequate anesthesia, post dural puncture headaches, and other potential complications. Ultrasound offers guidance to the physician for identification of the needle target, but accurate interpretation and localization remain challenges. A hybrid machine learning system is proposed to automatically localize the needle target for epidural needle placement in ultrasound images of the spine. In particular, a deep network architecture along with a feature augmentation technique is proposed for automatic identification of the anatomical landmarks of the epidural space in ultrasound images. Experimental results of the target localization on planes of 3-D as well as 2-D images have been compared against an expert sonographer. When compared with the expert annotations, the average lateral and vertical errors on the planes of 3-D test data were 1 and 0.4 mm, respectively. On 2-D test data set, an average lateral error of 1.7 mm and vertical error of 0.8 mm were acquired.
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Model-based registration of preprocedure MR and intraprocedure US of the lumbar spine. Int J Comput Assist Radiol Surg 2017; 12:973-982. [DOI: 10.1007/s11548-017-1552-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 02/27/2017] [Indexed: 10/19/2022]
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Zettinig O, Frisch B, Virga S, Esposito M, Rienmüller A, Meyer B, Hennersperger C, Ryang YM, Navab N. 3D ultrasound registration-based visual servoing for neurosurgical navigation. Int J Comput Assist Radiol Surg 2017; 12:1607-1619. [DOI: 10.1007/s11548-017-1536-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 02/01/2017] [Indexed: 12/27/2022]
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Seitel A, Sojoudi S, Osborn J, Rasoulian A, Nouranian S, Lessoway VA, Rohling RN, Abolmaesumi P. Ultrasound-Guided Spine Anesthesia: Feasibility Study of a Guidance System. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:3043-3049. [PMID: 27592559 DOI: 10.1016/j.ultrasmedbio.2016.07.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 05/19/2016] [Accepted: 07/09/2016] [Indexed: 06/06/2023]
Abstract
Spinal needle injections are guided by fluoroscopy or palpation, resulting in radiation exposure and/or multiple needle re-insertions. Consequently, guiding these procedures with live ultrasound has become more popular, but images are still challenging to interpret. We introduce a guidance system based on augmentation of ultrasound images with a patient-specific 3-D surface model of the lumbar spine. We assessed the feasibility of the system in a study on 12 patients. The system could accurately provide augmentations of the epidural space and the facet joint for all subjects. Following conventional, fluoroscopy-guided needle placement, augmentation accuracy was determined according to the electromagnetically tracked final position of the needle. In 9 of 12 cases, the accuracy was considered sufficient for successfully delivering anesthesia. The unsuccessful cases can be attributed to errors in the electromagnetic tracking reference, which can be avoided by a setup reducing the influence of the metal C-arm.
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Affiliation(s)
- Alexander Seitel
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, British Columbia, Canada
| | - Samira Sojoudi
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jill Osborn
- Department of Anesthesia, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Abtin Rasoulian
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, British Columbia, Canada
| | - Saman Nouranian
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, British Columbia, Canada
| | - Victoria A Lessoway
- Ultrasound Department, BC Women's Hospital, Vancouver, British Columbia, Canada
| | - Robert N Rohling
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, British Columbia, Canada; Department of Mechanical Engineering, University of British Columbia, Vancouver, British Columbia, Canada
| | - Purang Abolmaesumi
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, British Columbia, Canada.
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Herpetic Brachial Plexopathy: Application of Brachial Plexus Magnetic Resonance Imaging and Ultrasound-Guided Corticosteroid Injection. Am J Phys Med Rehabil 2016; 95:e67-71. [PMID: 26829085 DOI: 10.1097/phm.0000000000000445] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Herpes zoster, commonly known as shingles, is an infectious viral disease characterized by painful, unilateral skin blisters occurring in specific sensory dermatomes. Motor paresis is reported in 0.5% to 5% of patients. Although the mechanism of zoster paresis is still unclear, the virus can spread from the dorsal root ganglia to the anterior horn cell or anterior spinal nerve roots. It rarely involves the brachial plexus. We report a case of brachial plexitis following herpes zoster infection in which pathological lesions were diagnosed using brachial plexus magnetic resonance imaging and treated with ultrasound-guided perineural corticosteroid injection.
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Behnami D, Seitel A, Rasoulian A, Anas EMA, Lessoway V, Osborn J, Rohling R, Abolmaesumi P. Joint registration of ultrasound, CT and a shape+pose statistical model of the lumbar spine for guiding anesthesia. Int J Comput Assist Radiol Surg 2016; 11:937-45. [DOI: 10.1007/s11548-016-1369-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 02/26/2016] [Indexed: 11/30/2022]
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Rasoulian A, Seitel A, Osborn J, Sojoudi S, Nouranian S, Lessoway VA, Rohling RN, Abolmaesumi P. Ultrasound-guided spinal injections: a feasibility study of a guidance system. Int J Comput Assist Radiol Surg 2015; 10:1417-25. [DOI: 10.1007/s11548-015-1212-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 04/09/2015] [Indexed: 11/25/2022]
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Pesteie M, Abolmaesumi P, Ashab HAD, Lessoway VA, Massey S, Gunka V, Rohling RN. Real-time ultrasound image classification for spine anesthesia using local directional Hadamard features. Int J Comput Assist Radiol Surg 2015; 10:901-12. [DOI: 10.1007/s11548-015-1202-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 04/01/2015] [Indexed: 02/07/2023]
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Brudfors M, Seitel A, Rasoulian A, Lasso A, Lessoway VA, Osborn J, Maki A, Rohling RN, Abolmaesumi P. Towards real-time, tracker-less 3D ultrasound guidance for spine anaesthesia. Int J Comput Assist Radiol Surg 2015; 10:855-65. [DOI: 10.1007/s11548-015-1206-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 04/03/2015] [Indexed: 11/28/2022]
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