Photo Credit: Henadzi Pechan
The following is a summary of “Feasibility of Ultrasound-Guided Lumbar Transforaminal Epidural Steroid Injections for Management of Lumbar Radicular Back Pain,” published in the February 2025 issue of Journal of Pain Research by Vydyanathan et al.
Researchers conducted a retrospective study to evaluate the feasibility of ultrasound-guided transforaminal epidural steroid injections (TFESI) in the lumbar spine compared to traditional fluoroscopy.
They enrolled individuals who met the inclusion criteria (BMI < 25) and exclusion criteria (absence of spinal deformity or prior lumbar surgery). Ultrasound was used to visualize the lumbar nerve root and guide needle placement near the target site. Vascular signals were monitored throughout the procedure. Contrast injection was performed under real-time ultrasound guidance. The accuracy of final needle placement and transforaminal epidural spread was confirmed using contrast fluoroscopy. Any complications were documented.
The results showed that 30 ultrasound-guided lumbar TFESI were performed. Successful visualization was achieved at the L2, L3, and L4 levels. At the L5 level, the needle tip was positioned near the nerve root, but transforaminal placement and injection were not directly visualized, requiring fluoroscopic guidance. No intravascular injection was detected with no complications.
Investigators concluded that ultrasonography was feasible for localizing lumbar intervertebral foramina at higher lumbar levels in individuals with normal BMI and no spinal deformities, though fluoroscopy was required for transforaminal needle placement at the L5 level.
