Lumbar Disc Herniation Clinical Trial
Official title:
The Effect of Ultrasound Guidance on Radiation Dose and Procedure Time in Lumbar Transforaminal Epidural Injection
Low back pain is one of the leading causes of disability, and its social burden and economic cost are quite high. Although there are many causes that can lead to low back pain, radicular pain, which develops mostly secondary to lumbar disc hernias, is one of the most common pathologies. Epidural corticosteroid and local anesthetic injections are an important treatment option in the treatment of lumbar radicular pain that does not respond to conservative methods. For fluoroscopy-guided epidural injections; transforaminal, interlaminar and caudal approaches may be preferred. It is accepted as the superiority of the transforaminal approach that it allows access to the area of pathology, thus to the anterior epidural area where inflammatory mediators are more concentrated, and that it can spread to the target specifically around the inflamed nerve roots. In transforaminal epidural injections, the use of ultrasound as the sole imaging tool throughout the entire procedure is still not appropriate, as subbony structures cannot be visualized. However, ultrasound can be integrated at any stage of the process. Thus, the relatively inexpensive cost, portability, and ability to show non-osseous tissues of ultrasonography are utilized, particularly in terms of reducing radiation exposure. Gofeld et al. claimed that ultrasound-guided transforaminal epidural injection could be performed by targeting the posterior part of the vertebral body. However, in cases where the lamina is wide and covers the posterior of the vertebral body, it may not be possible to sonographically view the vertebral body. In addition, although the intervertebral disc is differentiated from the corpus, loss of fluid content in the elderly can cause acoustic shadowing in the disc. This may result in accidental intra-disc injections. Finally, even if the target point is reached, it is not possible to show intravascular spread at this level ultrasonographically. Therefore, in our opinion, this method is unreliable for transforaminal epidural injections. Another study used ultrasound and fluoroscopy together for transforaminal epidural injections. After imaging the lamina of the relevant vertebral level sonographically, the needle is directed to the lateral edge of the lamina, then fluoroscopic imaging is performed after it passes under the lamina with the loss of resistance technique. However, it should be known that the loss of resistance technique is not a suitable and reliable method in transforaminal injections. In addition, since it is not known how far the lamina has progressed after it has passed under the bone, in other words, imaging guidance is disabled in this part of the process. In our clinic, we use ultrasonography and fluoroscopy methods in an integrated way (hybrid method) for transforaminal epidural injections. For this purpose, we proceed to fluoroscopic imaging immediately after the spinal needle is advanced to the lateral edge of the lamina at the vertebral level where there is pathology with ultrasound. We think that with this method, we continue to stay in the safe window and reduce the radiation dose and procedure time. Based on this, we determined the aim of this study as the effect of including ultrasonography guidance in transforaminal epidural injections on radiation dose and procedure time.
n/a
Status | Clinical Trial | Phase | |
---|---|---|---|
Recruiting |
NCT05277818 -
Post-marketing Clinical Follow-up of the Medical Device DIVA®
|
||
Recruiting |
NCT05467072 -
PMCFU of an Annular Closure System
|
||
Withdrawn |
NCT03252691 -
Incidence of Large Annular Defects in Primary Lumbar Discectomy Patients
|
||
Withdrawn |
NCT01622413 -
Trial to Show Non-inferiority / Superiority of an Endoscopic Transforaminal Discectomy to Standard Microdiscectomy
|
N/A | |
Completed |
NCT04329598 -
Effects of Whole-Body Electromyostimulation Application in Individuals With Lumbar Disc Hernia
|
N/A | |
Completed |
NCT04061759 -
Physiotherapy in Lumbar Disc Pathologies
|
N/A | |
Completed |
NCT04073095 -
Erector Spinae Plane Block and Modified-Thoracolumbar Interfascial Plane Block Following Lumbar Spinal Surgery
|
N/A | |
Active, not recruiting |
NCT06140862 -
Ankle Spine Syndrome "RAFFET Syndrome II
|
N/A | |
Active, not recruiting |
NCT05613179 -
Brain Effect Mechanism of Lever Positioning Manipulation on LDH Analgesia Based on Multimodal MRI
|
N/A | |
Completed |
NCT04587401 -
The Effects of Anesthesia on Cerebral Perfusion in Patients With High Blood Pressure
|
N/A | |
Recruiting |
NCT05663437 -
Effectiveness of Core Stabilization Exercises With and Without Neural Mobilization Technique in Female Patients With Lumbar Radiculopathy Due to Disc Herniation - an RCT Study
|
N/A | |
Recruiting |
NCT06076408 -
Effects of SNAGS With and Without Pilates in Lumbar Disc Bulge Patients
|
N/A | |
Completed |
NCT05999253 -
Comparison of the Efficacy of Thoracolumbar Interfascial Plane Block and Erector Spina Plane Block in Lumbar Discectomy
|
||
Recruiting |
NCT03002207 -
Repairing the Defect of Intervertebral Disc With Autologous BMSC and Gelatin Sponge After Microendoscopic Discectomy for Lumbar Disc Herniation
|
N/A | |
Not yet recruiting |
NCT05487690 -
Application of 3D Printing Guide Plate in Spinal Minimally Invasive and Interventional Surgeries
|
N/A | |
Completed |
NCT05003726 -
Non-pharmacological Treatment and Pharmacological Treatment for Non-acute Lumbar Disc Herniation
|
N/A | |
Completed |
NCT05556538 -
The Effect of Subcutaneous Fat Tissue Thickness on Lumbar Transforaminal Epidural Steroid Injection Treatment Success
|
||
Not yet recruiting |
NCT04083703 -
Evaluation of Interbody Cage Insertion in Treatment of Lumbar Disc Prolapse
|
N/A | |
Completed |
NCT03832036 -
The Diagnostic and Prognostic Value of Two Quantitative Clinical Tests in Patients With Lumbar Disc Herniation
|
N/A | |
Not yet recruiting |
NCT05584774 -
Percutaneous Endoscopic Lumbar Discectomy Add by Annuloplasty and Nucleoplasty
|
N/A |