L Michael Kershen1,2, Nicholas C Nacey1, James T Patrie3, Michael G Fox4. 1. Department of Radiology and Medical Imaging, University of Virginia, 1218 Lee Street, Box 800170, Charlottesville, VA, 22908, USA. 2. Colorado Imaging Associates, 1819 Denver W Dr #101, Golden, CO, 80401, USA. 3. Department of Public Health Sciences, University of Virginia, PO Box 800717, Charlottesville, VA, 22908, USA. 4. Department of Radiology and Medical Imaging, University of Virginia, 1218 Lee Street, Box 800170, Charlottesville, VA, 22908, USA. mf3kx@virginia.edu.
Abstract
PURPOSE: To determine the accuracy and short-term efficacy of fluoroscopy-guided steroid/anesthetic injections for symptomatic pars interarticularis (pars) defects. MATERIALS AND METHODS: Following IRB approval, all fluoroscopically guided pars injections from a single institution (6/2010 to 3/2016) were retrospectively and independently reviewed by two MSK radiologists. The radiologists evaluated the fluoroscopic images to determine if all of the pars injections associated with each procedure were intra-pars (n = 57 procedures; 106 pars injections), peri-pars (n = 3 procedures; three pars injected), or a combination of intra-pars and peri-pars (n = 6 procedures; 12 pars injected). The patients were asked their pain score (graded on a scale of 0-10) pre-injection, 5-10 min and 1-week post-injection. Age, gender, and fluoroscopic times were recorded. Statistical analysis was performed on the all intra-pars injections only. RESULTS: Exact inter-reader agreement was present in 92 % (112/121) of the injections, with 57 of the procedures (106 pars injections) performed on 41 patients (mean age 36; 18 M, 23 F) all intra-pars. The mean pre-injection and 5-10 min post-injection reduction in pain for the all intra-pars injections was -3.0 units (95 % CI: [-3.9, -2.1] units; p < 0.001) with a mean 1-week post-injection (n = 21 procedures; 38 pars) reduction in pain of -0.7 units (95 % CI [-1.5, 0.0]; p = 0.06). The geometric mean fluoroscopic time per pars injected was 42 s. CONCLUSIONS: Over 92 % of fluoroscopically guided injections for symptomatic spondylolysis are technically successful with minimum fluoroscopic time, resulting in statistically significant pain reduction immediately post-injection and a trend in pain reduction 1-week post-injection.
PURPOSE: To determine the accuracy and short-term efficacy of fluoroscopy-guided steroid/anesthetic injections for symptomatic pars interarticularis (pars) defects. MATERIALS AND METHODS: Following IRB approval, all fluoroscopically guided pars injections from a single institution (6/2010 to 3/2016) were retrospectively and independently reviewed by two MSK radiologists. The radiologists evaluated the fluoroscopic images to determine if all of the pars injections associated with each procedure were intra-pars (n = 57 procedures; 106 pars injections), peri-pars (n = 3 procedures; three pars injected), or a combination of intra-pars and peri-pars (n = 6 procedures; 12 pars injected). The patients were asked their pain score (graded on a scale of 0-10) pre-injection, 5-10 min and 1-week post-injection. Age, gender, and fluoroscopic times were recorded. Statistical analysis was performed on the all intra-pars injections only. RESULTS: Exact inter-reader agreement was present in 92 % (112/121) of the injections, with 57 of the procedures (106 pars injections) performed on 41 patients (mean age 36; 18 M, 23 F) all intra-pars. The mean pre-injection and 5-10 min post-injection reduction in pain for the all intra-pars injections was -3.0 units (95 % CI: [-3.9, -2.1] units; p < 0.001) with a mean 1-week post-injection (n = 21 procedures; 38 pars) reduction in pain of -0.7 units (95 % CI [-1.5, 0.0]; p = 0.06). The geometric mean fluoroscopic time per pars injected was 42 s. CONCLUSIONS: Over 92 % of fluoroscopically guided injections for symptomatic spondylolysis are technically successful with minimum fluoroscopic time, resulting in statistically significant pain reduction immediately post-injection and a trend in pain reduction 1-week post-injection.
Authors: Leonid Kalichman; David H Kim; Ling Li; Ali Guermazi; Valery Berkin; David J Hunter Journal: Spine (Phila Pa 1976) Date: 2009-01-15 Impact factor: 3.468
Authors: John T Wald; Jennifer R Geske; Felix E Diehn; Naveen S Murthy; Timothy J Kaufmann; Kent R Thielen; Jonathan M Morris; Vance T Lehman; Vance Lehman; Timothy P Maus Journal: Pain Med Date: 2014-01-21 Impact factor: 3.750