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Ultrasound-Guided and CT-Navigation-Assisted Periradicular and Facet Joint Injections in the Lumbar and Cervical Spine: A New Teaching Tool to Recognize the Sonoanatomic Pattern
  1. Klaus Galiano, M.D.,
  2. Alois Albert Obwegeser, M.D., M.S.,
  3. Reto Bale, M.D.,
  4. Christoph Harlander, M.D.,
  5. Reinhold Schatzer, M.S.,
  6. Michael Schocke, M.D. and
  7. Hannes Gruber, M.D.
  1. Clinic of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria
  2. Clinic of Radiology, Medical University of Innsbruck, Innsbruck, Austria
  3. Institute of Anatomy and Histology, Medical University of Innsbruck, Innsbruck, Austria
  4. RTI International, Durham, NC.
  1. Reprint requests: Alois Albert Obwegeser, M.D., M.S., Clinic of Neurosurgery, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. E-mail: klaus.galiano{at}; alois.obwegeser{at}


Background and Objectives The aim of this study is to provide a teaching tool to facilitate the acquirement of periradicular and facet-joint infiltration techniques in the cervical and lumbar spine.

Methods On 3 fresh cadavers, a computed tomography (CT) of the lumbar and cervical region was obtained. By use of a dedicated image navigation and reconstruction system, sonographic images were generated and fused with the collected CT data set.

Results The sonoanatomy can be instantly compared with the correlating CT-images. This new bimodal method allows for simultaneous views of CT and ultrasound images. Multiplanar imaging of ultrasound-guided infiltrations is facilitated.

Conclusions This teaching tool provides immediate CT-verification of sonographically identified structures and helps in the identification of bony landmarks, which are necessary for facet-joint and periradicular injections.

  • Facet-joint injections
  • Periradicular injections
  • Navigation
  • Ultrasound

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