Correlation between epidural space depth measured with ultrasound and MRI compared to clinical loss of resistance when performing lumbar epidural steroid injection.

Autor:	Singh N; Department of Anesthesiolgy and Pain Medicine, University of California Davis, Sacramento, California, USA naisingh@ucdavis.edu., Pritzlaff S; Department of Anesthesiolgy and Pain Medicine, University of California Davis, Sacramento, California, USA., Bautista B; School of Medicine, University of California Davis, Sacramento, California, USA., Yan C; School of Medicine, University of California Davis, Sacramento, California, USA., Wilson MD; Public Health Sciences, Division of Biostatistics, University of California Davis, School of Medicine, Sacramento, California, USA., Chang J; Department of Radiology, University of California San Diego, La Jolla, California, USA., Fishman SM; Department of Anesthesiolgy and Pain Medicine, University of California Davis, Sacramento, California, USA.
Jazyk:	angličtina
Zdroj:	Regional anesthesia and pain medicine [Reg Anesth Pain Med] 2024 Dec 02; Vol. 49 (12), pp. 871-876. Date of Electronic Publication: 2024 Dec 02.
DOI:	10.1136/rapm-2023-105135
Abstrakt:	Background: This prospective study assessed the accuracy of MRI and ultrasound (US) measurements as a preprocedural assessment tool for predicting clinical loss of resistance depth (CLORD) during fluoroscopy-guided lumbar epidural steroid injections (ESIs). Materials and Methods: Sixty patients enrolled received lumbar ESIs at an academic chronic pain clinic. The MRI measurement calculated the distance between the skin and the posterior epidural space, while US measurements included transverse and parasagittal oblique views of the interlaminar space. The epidural space measurements were compared with the CLORD during the performance of the prone epidural injections. The differences in measurements were analyzed using two one-sided tests for equivalency with a 0.5 equivalency margin. The intraclass correlation coefficients between CLORD and the imaging modalities were estimated using mixed effects models. Results: MRI was equivalent to CLORD with a mean difference of -0.2 cm (95% CI -0.39 to -0.11). US transverse and US parasagittal oblique measurements were not equivalent to and underestimated CLORD with mean differences of -0.98 cm (90% CI -1.8 to -0.77) and -0.79 cm (90% CI -1.0 to -5.9), respectively. The intraclass correlation coefficients between MRI and CLORD were the highest at 0.85, compared with 0.65 and 0.73 for transverse and parasagittal oblique US views, respectively. Conclusions: MRI measurements are preferable over US for preprocedural assessment of patients receiving lumbar ESIs for predicting CLORD. Competing Interests: Competing interests: NS: none. SP: SPR Therapeutics, Nalu Medical, and Bioventus (Consultant); Nevro, Medtronic, Biotronik, Abbott (Educational Grants); Wolters Kluwer, Oxford University Press (Royalties). BB: none. CY, BS: none. Machelle Wilson-none. JC: none. SMF: Research Grants from NIH, SAMHSA, California Department of Healthcare Services Royalties on books and publications from Wolters Kluwer Publishers, Elsevier Publisher, Oxford University Press. (© American Society of Regional Anesthesia & Pain Medicine 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu