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Published in: International Journal of Computer Assisted Radiology and Surgery 9/2015

01-09-2015 | Original Article

Ultrasound-guided spinal injections: a feasibility study of a guidance system

Authors: Abtin Rasoulian, Alexander Seitel, Jill Osborn, Samira Sojoudi, Saman Nouranian, Victoria A. Lessoway, Robert N. Rohling, Purang Abolmaesumi

Published in: International Journal of Computer Assisted Radiology and Surgery | Issue 9/2015

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Abstract

Purpose

Facet joint injections of analgesic agents are widely used to treat patients with lower back pain. The current standard-of-care for guiding the injection is fluoroscopy, which exposes the patient and physician to significant radiation. As an alternative, several ultrasound guidance systems have been proposed, but have not become the standard-of-care, mainly because of the difficulty in image interpretation by the anesthesiologist unfamiliar with the complex spinal sonography.

Methods

We introduce an ultrasound-based navigation system that allows for live 2D ultrasound images augmented with a patient-specific statistical model of the spine and relating this information to the position of the tracked injection needle. The model registration accuracy is assessed on ultrasound data obtained from nine subjects who had prior CT images as the gold standard for the statistical model. The clinical validity of our method is evaluated on four subjects (of an ongoing in vivo study) which underwent facet joint injections.

Results

The statistical model could be registered to the bone structures in the ultrasound volume with an average RMS accuracy of \(2.3\pm 0.4\) mm. The shape of the individual vertebrae could be estimated from the US volume with an average RMS surface distance error of \(1.5\pm 0.4\) mm. The facet joints could be identified by the statistical model with an average accuracy of \(5.1\pm 1.5\) mm.

Conclusions

The results of this initial feasibility assessment suggest that this ultrasound-based system is capable of providing information sufficient to guide facet joint injections. Further clinical studies are warranted.
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Metadata
Title
Ultrasound-guided spinal injections: a feasibility study of a guidance system
Authors
Abtin Rasoulian
Alexander Seitel
Jill Osborn
Samira Sojoudi
Saman Nouranian
Victoria A. Lessoway
Robert N. Rohling
Purang Abolmaesumi
Publication date
01-09-2015
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Computer Assisted Radiology and Surgery / Issue 9/2015
Print ISSN: 1861-6410
Electronic ISSN: 1861-6429
DOI
https://doi.org/10.1007/s11548-015-1212-3

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