La radiologia medica

, Volume 123, Issue 11, pp 851–859 | Cite as

Real-time fusion-imaging in low back pain: a new navigation system for facet joint injections

  • Elena Massone
  • Davide OrlandiEmail author
  • Alberto Bellelli
  • Fabio Martino
  • Luca Cavagnaro
  • Matteo Formica
  • Pietro Caruso
  • Enzo Silvestri


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.


Facet 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.

Ethical approval

Local Institutional Review Board approval was obtained before starting the study.

Informed consent

All the included patients gave oral and written informed consent.


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Copyright information

© Italian Society of Medical Radiology 2018

Authors and Affiliations

  1. 1.Department of RadiologyGenoa UniversityGenoaItaly
  2. 2.Diagnostica per Immagini e Ecografia Interventistica, Ospedale Evangelico InternazionaleGenoaItaly
  3. 3.Radiologia Diagnostica ed Interventistica Ospedale San Pietro FatebenefratelliRomeItaly
  4. 4.Radiologia Ambulatoriale, ASL BABariItaly
  5. 5.Clinica OrtopedicaIRCCS Azienda Ospedaliera Universitaria San MartinoGenoaItaly

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