Journal of Korean Society of Spine Surgery (대한척추외과학회지)

Korean Society of Spine Surgery (대한척추외과학회)
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Ultrasound-Guided Injections in the Lumbar and Sacral Spine

요추 및 천추부에 대한 초음파 유도하 중재 시술

  • Ko, Kwang Pyo (Hanmaeum Orthopaedic Clinic) ;
  • Song, Jae Hwang (Department of Orthopedic Surgery, Konyang University Hospital) ;
  • Kim, Whoan Jeang (Department of Orthopedic Surgery, Eulji University Hospital) ;
  • Kim, Sang Bum (Department of Orthopedic Surgery, Konyang University Hospital) ;
  • Min, Young Ki (Department of Orthopedic Surgery, Konyang University Hospital)
  • 고광표 (한마음정형외과의원) ;
  • 송재황 (건양대학교 의과대학 정형외과학교실) ;
  • 김환정 (을지대학교 의과대학 정형외과학교실) ;
  • 김상범 (건양대학교 의과대학 정형외과학교실) ;
  • 민영기 (건양대학교 의과대학 정형외과학교실)
  • Received : 2018.07.27
  • Accepted : 2018.10.17
  • Published : 2018.12.30
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Abstract

Study Design: Literature review. Objective: Ultrasound-guided injections are a common clinical treatment for lower lumbosacral pain that are usually performed before surgical treatment if conservative treatment fails. The aim of this article was to review ultrasound-guided injections in the lumbar and sacral spine. Summary of Literature Review: Ultrasound-guided injections, unlike conventional interventions using computed tomography or C-arm fluoroscopy, can be performed under simultaneous observation of muscles, ligaments, vessels, and nerves. Additionally, they have no radiation exposure and do not require a large space for the installation of equipment, so they are increasingly selected as an alternative method. Materials and Methods: We searched for and reviewed studies related to the use of ultrasound-guided injections in the lumbar and sacral spine. Results: In order to perform accurate ultrasound-guided injections, it is necessary to understand the patient's posture during the intervention, the relevant anatomy, and normal and abnormal ultrasonographic findings. Facet joint intra-articular injections, medial branch block, epidural block, selective nerve root block, and sacroiliac joint injections can be effectively performed under ultrasound guidance. Conclusions: Ultrasound-guided injections in the lumbar and sacral spine are an efficient method for treating lumbosacral pain.

연구 계획: 문헌 조사 목적: 초음파를 이용한 중재 시술은 임상적으로 흔하게 경험할 수 있는 하요추부 통증이 보존적 치료에 실패한 경우 수술적 치료 이전에 흔하게 시행하게 되는 치료이다. 이 연구의 목적은 요추 및 천추부에 대한 초음파 유도하 중재 시술에 대해 고찰해 보고자 함에 있다. 선행 연구문헌의 요약: 초음파를 이용한 중재 요법은 근육, 인대, 건, 혈관, 신경 등의 연부조직을 직접 관찰할 수 있으며, 환자나 시술자에게 방사선 노출이 없고, 컴퓨터 단층 촬영이나 C형 투시검사 장비처럼 넓은 장소를 필요로 하지 않는 장점들을 가지고 있기 때문에 점차 그 사용이 늘고 있다. 대상 및 방법: 요추부의 정상, 비정상 초음파 소견과 요추 및 천추부에서 시행할 수 있는 초음파 유도하 중재 요법에 대하여 문헌 고찰과 함께 기술을 하였다. 결과: 요천추부의 정확한 초음파 중재 시술을 위해서는 검사 시 환자의 자세 및 해부학과 정상, 비정상 초음파 소견 등에 대한 숙지가 필요하다. 초음파를 이용하면 후방 관절 내 주사 및 내측 분지 차단술, 경막외 차단술, 선택적 신경근 차단술, 천장관절 주사를 효과적으로 시행할 수 있다. 결론: 요추 및 천추부에서 초음파 유도하 중재 요법은 요천추부 통증의 치료에서 효과적으로 사용할 수 있는 술기이다.

Keywords

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