Real-time fusion-imaging in low back pain: a new navigation system for facet joint injections
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Aims and Objectives
The aim of the current study is to present our experience in lumbar spine interventional procedures performed with a newly developed multimodal echo-navigator (EcoNav) and to evaluate short-term clinical outcomes of a series of patients affected by facet joint disease (FJD) treated with steroid and anaesthetic injection under fusion-imaging guidance, compared to a cohort of patients that received the same treatment under computed tomography (CT) guidance.
Sixty-five consecutive patients (34 females; mean age 68.3 ± 12.8 years) with a clinical diagnosis of non-radicular low back pain lasting for more than 6-weeks and magnetic resonance (MR) or CT confirmed FJD were enrolled for image-guided FJI. Twenty-eight patients underwent FJI with fusion-guided technique, while CT-guided procedures were performed in the other cases. Clinical and procedural data were recorded and compared at a mean follow-up of 6.1 ± 2.0 months.
A significant improvement in clinical parameters was observed for both fusion-guided and CT-guided group. Comparing both groups, no statistically significant difference could be detected neither at baseline conditions nor during the follow-up period. No significant periprocedural complication occurred in both groups. A satisfaction rate of 92.3 and 81.1% was reported for fusion-guided and CT-guided group, respectively.
EcoNav fusion-imaging system represents a safe, feasible, effective and reproducible guidance option in FJD infiltration procedures, also avoiding use of ionising radiations.
KeywordsFacet joints injection Spine Fusion-imaging Ultrasound guidance Magnetic resonance Computed tomography Minimally invasive spine
Fabio Martino, Alberto Bellelli, and Enzo Silvestri acknowledge a non-financial consultancy relationship with MASMEC S.P.A., Modugno (BA), Italy.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Local Institutional Review Board approval was obtained before starting the study.
All the included patients gave oral and written informed consent.
- 26.Nishigori S, Numata K, Irie K, Fukuda H, Chuma M, Maeda S (2018) Fusion imaging with contrast-enhanced ultrasonography for evaluating the early therapeutic efficacy of radiofrequency ablation for small hypervascular hepatocellular carcinomas with iso-echoic or unclear margins on conventional ultrasonography. J Med Ultrason. https://doi.org/10.1007/s10396-018-0861-6 CrossRefGoogle Scholar
- 28.Schwein A, Kramer B, Chinnadurai P et al (2017) Electromagnetic tracking of flexible robotic catheters enables “assisted navigation” and brings automation to endovascular navigation in an in vitro study. J Vasc Surg S0741–5214(17):31106Google Scholar
- 33.Rouchy RC, Moreau-Gaudry A, Chipon E et al (2017) Evaluation of the clinical benefit of an electromagnetic navigation system for CT-guided interventional radiology procedures in the thoraco-abdominal region compared with conventional CT guidance (CTNAV II): study protocol for a randomised controlled trial. Trials 18(1):306CrossRefPubMedPubMedCentralGoogle Scholar