Fluoroscopy vs CT-guidance: Which method works best for lumbar spine injections?

Fluoroscopy-guided lumbar spine injections expose patients to less radiation than CT-guided procedures, but results in higher exposure for physicians, reported authors of a Jan. 8 study published in Radiology.

Swiss researchers included more than 600 patients ranging from 18 to 91 years old who had received transforaminal epidural injections or facet joint injections guided by CT or fluoroscopy in their study. Comparing the safety and efficiency of each, the team found no clinically-significant difference in patient outcomes according to patient-reported pain levels up to one month after the procedure.

However, dosimeters placed on the physicians’ wrists found their radiation exposure was 3.7 to 10 times higher for fluoroscopy compared to CT-guided injections. In patients, CT-guided lumbar transforaminal epidural injections resulted in 1.4 times more exposure compared to fluoroscopy, and 3.3. times more exposure when using CT-guided facet joint steroid injections.

“In summary, radiation exposure in fluoroscopy-guided lumbar spinal injections was significantly lower for participants and higher for physicians when compared with CT-guided injections and vice versa; however, no associations were observed between clinical participant outcomes and type of imaging-guided injection technique at all evaluated time points,” the authors wrote.