Comparing CT-guided and fluoroscopic-guided interventions for chronic low back pain management: a randomized trial

Area of Science:

• Interventional Radiology
• Pain Management
• Spinal Interventions

Background:

• Low back pain (LBP) with radicular symptoms is a significant cause of disability.
• Conservative treatments are often ineffective for radicular LBP.
• Fluoroscopy and computed tomography (CT) are used for guidance in interventions, but direct outcome comparisons are limited.

Purpose of the Study:

• To compare the clinical efficacy and safety of fluoroscopy-guided versus CT-guided interventions for radicular LBP.
• To evaluate pain reduction and functional improvement in patients undergoing these procedures.
• To assess secondary outcomes including operative time, radiation exposure, and patient satisfaction.

Main Methods:

• Prospective randomized controlled trial involving 200 adult participants with chronic radicular LBP.
• Participants were randomized 1:1 to receive either fluoroscopy-guided or CT-guided interventions.
• Pain (VAS) and disability (ODI) were assessed at multiple time points up to six months.

Main Results:

• No significant differences in Oswestry Disability Index (ODI) were observed between groups.
• Fluoroscopy-guided interventions showed statistically significant lower Visual Analog Scale (VAS) pain scores at one, three, and six months.
• Operative time, radiation exposure, complication rates, and patient satisfaction were similar between the fluoroscopy and CT groups.

Conclusions:

• Both fluoroscopy- and CT-guided interventions are safe and effective for managing radicular LBP.
• Fluoroscopy guidance provides modest advantages in short-term pain relief.
• CT guidance offers enhanced anatomical visualization, and the choice should be individualized.