Ultrasound-Guided vs. Fluoroscopy-Guided Interventions for Back Pain Management: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Viderman D. Aubakirova M. Aryngazin A. Yessimova D. Kaldybayev D. Tankacheyev R. Abdildin Y.G.
November 2023Multidisciplinary Digital Publishing Institute (MDPI)
Diagnostics
2023#13Issue 22
The objective of this study was to compare the outcomes of the ultrasound- and fluoroscopy-guided techniques in the management of back pain. Using PubMed, Scopus, and the Cochrane Library, we searched randomized controlled trials (RCTs) published before May 2023, which reported relevant data on the topic. The effectiveness of the ultrasound-guided (US-guided) and fluoroscopy-guided (FL-guided) approaches for back pain management was compared in terms of postoperative pain intensity, postoperative functional outcomes, and postoperative complications. Subgroup analyses were conducted for different postoperative periods. Eight studies were included in the analysis. There was no significant difference in post-procedural pain relief at one week, two weeks, one month, two months, and three months between the US-guided and FL-guided interventions for back pain management (SMD with 95% CI is −0.01 [−0.11, 0.10]), p = 0.91, I2 = 0%). In terms of the postoperative functional outcomes assessed by the “Oswestry Disability Index” (ODI) functionality score, the model tends to favor the FL-guided injections over the US-guided injections (SMD with 95% CI: 0.13 [−0.00, 0.25], p = 0.05, I2 = 0). Finally, the US-guided and FL-guided injections did not show significantly different results in terms of postoperative complications (RR with 95% CI is 0.99 [0.49, 1.99], p = 0.97, I2 = 0). The subgroup analysis also did not demonstrate differences between the US-guided and FL-guided techniques in the following outcomes: vasovagal reaction, transient headache, and facial flushing. There was no significant difference between the US-guided and FL-guided injections for treating back pain in terms of postoperative pain intensity and complications. Still, the model tends to favor the FL-guided injections over the US-guided injections in terms of functionality.
back pain management , fluoroscopy , injections , pain intensity , postoperative complications , ultrasound
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Department of Surgery, Section of Anesthesiology, Intensive Care, and Pain Medicine, Nazarbayev University School of Medicine (NUSOM), Astana, 020000, Kazakhstan
Department of Mechanical and Aerospace Engineering, School of Engineering and Digital Sciences, Nazarbayev University, Astana, 010000, Kazakhstan
Department of Health Care Management, Faculty of Economics & Management, Technische Universität Berlin, Berlin, 13355, Germany
Department of Pain Medicine, National Neurosurgery Center, Astana, 010000, Kazakhstan
Department of Surgery
Department of Mechanical and Aerospace Engineering
Department of Health Care Management
Department of Pain Medicine
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