Eric A Jones, Edward A Pingenot, Richard Kim, Amitabh Gulati
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引用次数: 0
Abstract
Introduction: Ultrasound-guided neuraxial injections are less accurate than fluoroscopy-guided techniques due to limited needle visualization, particularly in out-of-plane approaches. A novel dual-array ultrasound probe developed by Rivanna Medical Inc., enables in-plane visualization of needle trajectory even when inserted perpendicularly. This study evaluates the accuracy of this novel technology in thoracic and lumbar facet joint injections.
Methods: A prevalidation study was conducted using one cadaver. One interventional pain physician independently performed facet joint injections using the dual-array ultrasound system. The system integrates two rotated 64-element curvilinear arrays configured to transmit and receive at 2.5 MHz with multiangle electronic beam steering (three angles per array) and real-time dual-array image blending/compounding, enabling visualization of both anatomy and the full in-plane needle trajectory. Injection accuracy was confirmed via fluoroscopy.
Results: All six injections successfully targeted the intended region. Two injections were classified as Grade 1, three as Grade 2, one as Grade 3, and zero as Grade 4.
Conclusions: The dual-array ultrasound system shows promise in enhancing the accuracy of thoracic and lumbar facet joint injections by enabling in-plane needle visualization even at steep angles. Our findings highlight the potential of this technology to improve procedural precision, while also underscoring the learning curve associated with its use. These feasibility results support further validation for spine interventions requiring steep needle trajectories, and future studies should evaluate true neuraxial applications (e.g., epidural/intrathecal) with quantitative needle-tip localization metrics.
导读：超声引导下的轴突注射不如透视引导下的技术准确，因为针的可见性有限，特别是在平面外入路。Rivanna Medical Inc.开发了一种新型双阵列超声探头，即使垂直插入，也能在平面内显示针头轨迹。本研究评估了这种新技术在胸椎和腰椎关节突关节注射中的准确性。方法：采用一具尸体进行预验证研究。一名介入疼痛医生使用双阵列超声系统独立进行小关节注射。该系统集成了两个旋转的64单元曲线阵列，配置为以2.5 MHz的频率发射和接收，具有多角度电子束导向（每个阵列三个角度）和实时双阵列图像混合/复合，可以实现解剖结构和整个平面内针轨迹的可视化。通过透视检查确认注射准确性。结果：6次注射均成功靶向预定部位。2次为1级，3次为2级，1次为3级，0次为4级。结论：双阵列超声系统显示出提高胸椎和腰椎关节突关节注射准确性的希望，即使在陡峭的角度也能实现平面内针的可视化。我们的研究结果强调了这项技术在提高程序精度方面的潜力，同时也强调了与使用它相关的学习曲线。这些可行性结果支持进一步验证需要陡峭针头轨迹的脊柱干预措施，未来的研究应通过定量针头定位指标评估真正的神经轴应用（例如，硬膜外/鞘内）。
期刊介绍：
Pain Practice, the official journal of the World Institute of Pain, publishes international multidisciplinary articles on pain and analgesia that provide its readership with up-to-date research, evaluation methods, and techniques for pain management. Special sections including the Consultant’s Corner, Images in Pain Practice, Case Studies from Mayo, Tutorials, and the Evidence-Based Medicine combine to give pain researchers, pain clinicians and pain fellows in training a systematic approach to continuing education in pain medicine. Prior to publication, all articles and reviews undergo peer review by at least two experts in the field.
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