Evidence map›Paper›PMID 30887198›Full record

SynthesisEuropean radiology2019

Ultrasound- versus fluoroscopy-guided injections in the lower back for the management of pain: a systematic review.

Mark Hofmeister, Laura E Dowsett, Diane L Lorenzetti, Fiona Clement

Abstract readComparative StudySystematic Review
PubMed Publisher
In one paragraph

Synthesis in European radiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.4field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 21 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. An MR-Conditional Needle Driver for Robot-Assisted Spinal Injections: Design Modifications and Evaluations.Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference · 2022
    Article
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Mark HofmeisterDepartment of Community Health Sciences, University of Calgary, Teaching Research and Wellness Building, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada.
Laura E DowsettDepartment of Community Health Sciences, University of Calgary, Teaching Research and Wellness Building, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada.
Diane L LorenzettiDepartment of Community Health Sciences, University of Calgary, Teaching Research and Wellness Building, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada.
Fiona ClementDepartment of Community Health Sciences, University of Calgary, Teaching Research and Wellness Building, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada. fclement@ucalgary.ca.
University of Calgary · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeUltrasound-guided spinal injections are less common than fluoroscopy-guided injections. Although unable to penetrate bones, ultrasound guidance has a number of advantages including convenience and reduced exposure to ionizing radiation. However, it is not known how ultrasound-guided injections compare to fluoroscopy-guided injections in the management of lower back pain. Our objective is to systematically review the literature comparing ultrasound-guided injections to fluoroscopy-guided injections for the management of lower back pain.

methodsMedline, Cochrane CENTRAL Register of Controlled Trials, Embase, and NHSEED were searched from 2007 to September 26, 2017. Inclusion criteria included (1) randomized controlled trial design, (2) compared ultrasound-guided and fluoroscopy-guided injections for lower back pain, (3) dose and volume of medications injected were identical between trial arms, and (4) reported original data.

resultsOne hundred one unique records were identified, and 21 studies were considered for full-text inclusion. Nine studies formed the final data set. Studies comparing ultrasound- and fluoroscopy-guided injections for lower back pain management reported no difference in pain relief, procedure time, number of needle passes, changes in disability indices, complications or adverse events, post-procedure opioid consumption, or patient satisfaction.

conclusionFluoroscopic guidance of injections for the management of lower back pain is similar in efficacy to ultrasound guidance. The exact role of ultrasound guidance needs to be further studied, especially for nerve root injections, where safety is the major concern. KEY POINTS: • There were no differences in pain relief, procedure time, number of needle passes, changes in disability indices, complications or adverse events, post-procedure opioid consumption, or patient satisfaction between ultrasound- and fluoroscopy-guided injections for the management of lower back pain. • Given the lack of evidence to demonstrate superior efficacy and the added harms with fluoroscopic guidance, ultrasound guidance may be the preferred method of guidance for injections to manage lower back pain in appropriate patients. Further study is required to understand the exact role of ultrasound in image-guided injections.

Indexed as

Anesthetics, LocalDrug Therapy, CombinationFluoroscopyGlucocorticoidsHumansInjections, EpiduralLow Back PainPain ManagementRadiography, InterventionalUltrasonography, InterventionalAnesthetics, LocalGlucocorticoidsFluoroscopyLow back painUltrasonography

Identifiers

PMID30887198
OpenAlexW2921451319

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.