Ultrasound-Guided Lumbar Nerve Root Hydrodissection: Fluoroscopy-Assisted Evaluation of Injectate Distribution and...

Area of Science:

• Pain Management
• Interventional Radiology
• Neurology

Background:

• Selective nerve root block is typically guided by fluoroscopy, with limited data on ultrasound (US) guidance.
• Hydrodissection shows promise for peripheral nerves, but its application to lumbar nerve roots is less explored.

Purpose of the Study:

• To evaluate the injectate distribution, reproducibility, safety, and clinical efficacy of ultrasound-guided hydrodissection of the lumbar nerve root (US-HNR) with fluoroscopic assistance.

Main Methods:

• US-HNR was performed on 46 patients with lumbar radiculopathy.
• A standardized injectate was administered, and distribution patterns were assessed under fluoroscopy.
• Pain (NRS), disability (ODI), and patient satisfaction were evaluated pre- and post-procedure.

Main Results:

• Contrast localized to the periradicular region in 30% of cases; epidural spread occurred in 63%.
• Significant improvements were observed in NRS scores (7.1 to 3.8) and ODI (42 to 28) at 3 months.
• Responder rates for NRS and ODI were over 50%, with no serious complications.

Conclusions:

• US-HNR is a safe and feasible technique for lumbar radiculopathy, avoiding radiation and direct nerve puncture.
• The procedure demonstrated favorable clinical outcomes, including significant pain relief and functional improvement.
• US-HNR represents a promising treatment option for patients suffering from lumbar radiculopathy.