Lumbar Transforaminal and Nerve Root Injections: Ultrasound

Ultrasound (US) guidance has gained recognition in the field of regional anesthesia mainly because of its definite advantage of visually localizing the desired target and also due to perceived benefits of safety, accuracy, and efficiency when peripheral nerve blocks are performed. On the contrary, ultrasonography of the spinal structures may be challenging because of depth, bony acoustic shadowing, and complex three-dimensional anatomy. Nevertheless, US allows satisfactory imaging of the posterior elements of spine column and paraspinal soft tissues. This makes US applicable and practical in the outpatient clinical setting, and thus ultrasonography has been increasingly penetrating into chronic spinal pain management. Perhaps the major advantage of ultrasound-guided spine interventions is the lack of radiation exposure. Lumbar transforaminal injections are frequently performed for managing acute and chronic radicular pain, and US guidance may reduce overall radioactive contamination.