Comparison of the effectiveness of ultrasound-guided versus fluoroscopy-guided medial lumbar bundle branch block on pain related to lumbar facet joints: a multicenter randomized controlled non-inferiority study

BMC Anesthesiology

Research

Jonathan Gouwy¹  Emmanuel Guntz¹  Panayota Kapessidou²  Walid El Founas²  Turgay Tuna³  Djamal Ghoundiwal⁴  Marie-Laure Nisolle⁴  Edgard Engelman⁵ 

[1] Department of Anesthesiology and Pain Medicine, Braine l’Alleud Hospital, Université Libre de Bruxelles (ULB), Rue Wayez 35, 1420, Braine-l’Alleud, Belgium;Department of Anesthesiology and Pain Medicine, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), Rue aux Laines 105, 1000, Brussels, Belgium;Department of Anesthesiology and Pain Medicine, Erasme Hospital, Université Libre de Bruxelles (ULB), Route de Lennik 808, 1070, Brussels, Belgium;Department of Anesthesiology and Pain Medicine, Erasme Hospital, Université Libre de Bruxelles (ULB), Route de Lennik 808, 1070, Brussels, Belgium;Department of Anesthesiology and Pain Medicine, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), Rue aux Laines 105, 1000, Brussels, Belgium;EW Data analysis, Brussels, Belgium;

关键词: Low-back pain;    Chronic pain;    Ultrasonography;    Fluoroscopy;    Nerve block;    Zygapophyseal joint;    Lumbar facet joint syndrome;   

DOI  :  10.1186/s12871-023-02029-9

 received in 2022-12-07, accepted in 2023-02-27,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe aim of this multicenter randomized interventional prospective study was to compare the ultrasound (US)-guided lumbar medial branch block (LMBB) with the fluoroscopy (FS)-guided LMBB in terms of analgesic efficacy and disability in the setting of the treatment of pain arising from the lumbar facet joints (LFJ).MethodsFifty adults with a “LFJ” syndrome were randomized into two groups: in group FS, fluoroscopic-guidance was used to block the medial branch at three lumbar levels (L3-L4, L4-L5 and L5-S1); in group US, same blocks were performed under ultrasound. Needle transverse approach was used with both techniques. Effects of these procedures were assessed with a Visual Analogue Pain Scale (VAPS), the Oswestry Disability Index (ODI) and the Duke’s Activity Status Index (DASI) scale, before the treatment, 1 week and 1 month after. Hospital Anxiety and Depression Scale (HADS) score was also collected before the procedure. Analysis of variance, one (for non-inferiority) and two-sided Mann-Whitney tests and Chi-square tests were performed.ResultsLMBB under US-guidance was not inferior to FS-guidance (P = 0.047) in terms of VAPS, ODI and DASI at 1 week and 1 month. Duration of techniques and HADS were similar between groups (=0.34; p = 0.59).ConclusionsThe medial lumbar bundle branch block under ultrasound-guidance is not inferior to the fluoroscopy-guidance procedure in effectively alleviating pain arising from the facet joints. Considering that this ultrasound technique has the benefit of an irradiation-free, real-time procedure, it can be considered as an effective alternative to the fluoroscopy-guided technique.

【 授权许可】

CC BY   
© The Author(s) 2023. corrected publication 2023

【 图 表 】

Fig. 1

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