Usefulness of a pre-procedure ultrasound scanning of the lumbar spine before epidural injection in patients with a presumed difficult puncture: A randomized controlled trial

Joint, Bone, Spine : Revue Du Rhumatisme
Christelle Darrieutort-LaffiteBenoit Le Goff

Abstract

Ultrasound (US) is widely used in rheumatology to study and guide injection of peripheral joints. It can also provide useful information about the anatomy of the lumbar spine. Studies have shown that US examination of the spine was a useful tool to help perform epidural anaesthesia. The purpose of the study was to determine if the selection of the optimum puncture level by US may facilitate epidural steroid injection in case of presumed difficult puncture (BMI>30 kg/m(2), age>60 years or lumbar scoliosis). We performed a prospective randomized controlled study. Eighty patients were randomized in two groups: US group (n=40) which underwent a pre-procedure spinal US to determine the optimal lumbar level for injection or control group (n=40) for which the level of injection was determined by palpation. Primary endpoint was the pain during the procedure assessed using the Visual Analogue Scale (VAS). We found a positive correlation between depth of the epidural space and BMI (P<0.001) and a negative correlation between size of the interspinous spaces and age (P<0.01). Visibility of the epidural space was not altered by obesity or age. We observed a trend toward a reduction in pain intensity during the procedure in the US group comp...Continue Reading

Associated Clinical Trials

Sep 18, 2015·Georgios KotsovolisGeorgios Kotsovolis

References

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Apr 30, 2013·Joint, Bone, Spine : Revue Du Rhumatisme·Paolo Falsetti, Caterina Acciai
Mar 13, 2014·Joint, Bone, Spine : Revue Du Rhumatisme·Christelle Darrieutort-LaffiteBenoit Le Goff
Mar 29, 2014·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Michael A PetersonRoger J Lewis

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