Ultrasound-Guided Versus Conventional Radioscopic-Guided Transforaminal Epidural Steroid Injections for Cervical...

Area of Science:

• Pain Management
• Interventional Radiology
• Musculoskeletal Medicine

Background:

• Cervical radicular pain management traditionally relies on radioscopic guidance for transforaminal injections.
• Ultrasound-guided transforaminal (USF) injections present a potentially faster and more accessible alternative.
• The efficacy and safety of USF for cervical interventions require further investigation.

Purpose of the Study:

• To compare the efficacy and safety of ultrasound-guided cervical transforaminal injections versus traditional radioscopic methods.
• To evaluate outcomes related to pain, disability, procedure time, and vascular injection risk.

Main Methods:

• A systematic review and meta-analysis of studies comparing US-guided and radioscopic-guided cervical transforaminal injections.
• Databases searched include Pubmed, Embase, and Cochrane Library.
• Outcomes analyzed include pain scores (SMD), Neck Disability Index (MD), procedure time (MD), and vascular injection risk (OR).

Main Results:

• Seven studies including 1104 patients were analyzed.
• Pain and disability outcomes were comparable between USF and radioscopic groups (SMD = 0.15; MD = 0.56).
• US guidance significantly reduced vascular injection risk (OR = 0.13) and procedure time (MD = -158 minutes).

Conclusions:

• Ultrasound-guided transforaminal injections are associated with reduced vascular injection risk and shorter procedure times compared to radioscopic guidance.
• No significant differences in pain relief or disability outcomes were observed between the two methods.
• USF is a viable and potentially safer alternative for cervical interventions.