Spinal interventions under ultrasound guidance

Injection therapies play important roles in the management of spinal pain and it has been preferred that they be performed under the guidance of computed tomography or fluoroscopy. Recently, several ultrasound-guided techniques for alleviating spinal pain have been introduced due to visualization of the inner structures, portability, and lack of radiation exposure. For the cervical spine, ultrasound-guided procedures including the nerve root block, facet joint injection, and medial branch block have shown successful results, and for the lumbar spine, so do the interventions including the interlaminar epidural block, nerve root block, facet joint injection, and medial branch block. However, ultrasonographically guided procedures have some limitations in that they cannot completely avoid unintentional intravascular injection and identify the spread pattern of injected solution underneath the bony structures. New and untried techniques to overcome these limitations are expected. This paper reviews a variety of techniques under ultrasound guidance that have been reported for injection therapy in the cervical and lumbar spine.