Background: Ultrasound can provide imaging with good visualization of the nerve roots, which aids greatly in interventions such as selective nerve root injection (SNRI). Objectives: To evaluate the efficacy and safety of ultrasound in selective lumbar nerve root injection compared with fluoroscopy-guided injections for the treatment of lumbar radicular pain. Methods: 74 patients who received an SNRI for unilateral lumbar radicular pain were split into two equal group: The ultrasound group (US) or the fluoroscopy group (FL). A mixture of 5 ml of injectate consisting of 3 ml of 1% lidocaine and 2 ml (8 mg) of dexamethasone was used. The efficacy of ultrasound was detected by the assessment of the Visual Analogue Scale (VAS), the patient's Oswestry disability index (ODI), and analgesic needs. The time of procedure, complications, and the accuracy of the needle tip in the US group detected by fluoroscopy were recorded. The data was collected before the injection, one, two weeks, one, two, and three months after the injection. Results: VAS scores, ODI, and analgesic requirements were significantly lowered in both groups compared to baseline, and there was no significant difference between the two groups. The time procedure in the US group was lower in comparison to the FL group (P value <0.001), with no significant complication in both groups. Also, the accuracy of ultrasound-guided needle positioning was 91.9%.
Conclusions: The ultrasound-guided SNRI via fluoroscopic evaluation is as efficient and safe as a fluoroscopy-guided injection in treating lumbar radicular pain.