Table 2.
Comparison of different approaches of ultrasound transforaminal injection
| Author (year) | Subjects | Needle orientation | Probe/final probe position | Needle target | CT or FL | Study result | Failure | Complications | |
|---|---|---|---|---|---|---|---|---|---|
| Axial approach | |||||||||
| Galiano et al. [11] (2005) | Cd 1: 10 | In plane | C/lateral to lower margin of lamina | Between LF & VB | Axial CT | All NT at dorsal 1/3 IVF | None | ND | |
| Gofeld et al. [13] (2012) | Cd5: 50 | In plane | C/intertransverse | Most medially visible shadow of VB | FL | IF: 42 (ventral IVF 91.7%); EF: 4 | L5–S1: 4/10 | Intravascular: 3 | |
| Wan et al. [17] (2017 RCT) | P25: 25 | Axial/in plane | C/SP | Lateral to lamina/medial to SAP | CT | Correct spinal segment identification: 100%; accuracy: 95.7% | 2/25 | None | |
| Parasagittal approach | |||||||||
| Loizides et al. [12] (2011) | Cd1: 10 | In plane | C/PAP | ITL | CT | All NT at PAP | ND | ND | |
| Loizides et al. [14] (2013 RCT) | P20: 20 | In plane | C/PAP | ITL | CT | 18 NT at PAP | 2 | ND | |
| Kim et al. [15] (2015) | P42: 45 | In plane | C/PAP | ITL/parasagittal | FL | IF: 17/43 (39.5%) | 2 at L5 | Intravascular: 2 | |
| P42: 45 | In plane | C/PAP | ITL/PSO | FL | IF-:35/40 (87.5%) | 5 at L5 | Intravascular: 2 | ||
| Wan et al. [17] (2017 RCT) | P21: 21 | Parasagittal/out of plane | Edge of ZPJ | Between facets | CT | Correct spinal segment identification: 100%; accuracy: 95% | 1/21 | None | |
| Combined axial and parasagittal approach | |||||||||
| Yang et al. [18] (2016 RCT) | P80: 80 (ultrasound: 40/FL: 40) | Axial/in plane followed by parasagittal/out of plane | Axial-over SP; followed by parasagittal-edge of ZPJ | Axial-LL; parasagittal between facets | FL | Correct NT: L3–4: 5/7 (71.4%); L4–5: 29/33 (87.9%) | L3–4: 2/7; L4–5: 4 /33 | None | |
Cd, cadavers; C, curvilinear probe; LF, lateral facet; VB, vertebral body; CT, computed tomography; NT, needle tip; IVF, intervertebral foramen; ND, not defined; FL, fluoroscopy; IF, intraforaminal; EF, extraforaminal; RCT, randomized controlled trial; P, patient; SP, spinous process; SAP, superior articular process; PAP, pararadicular aditus plane; ITL, intertransverse ligament; PSO, parasagittal oblique; ZPJ, zygapophysial joints; LL, lateral side of lamina.