Using the CT as a Guided Imaging Modality in Spinal Injections for Chronic Low Backache; Is it the Preferred Modality?

Abstract Background: Low back pain is the most common cause of disability in people under 45 years of age. In such patients, spinal injections allow a functional assessment of the anatomic structures that are suspected to be the cause of pain. To minimize the complications and maximize test of accuracy, spinal injections are best performed with imaging guidance. Aim of Study: The aim of the study is to evaluate the role of CT guided spinal injections in management of chronic low back pain. Methods and Material: 120 patients with chronic low back pain after failure of adequate conservative treatment for at least 6 months were enrolled in this study. We excluded patients with focal discs herniation, motor deficit, and bleeding tendency. All our study population were subjected to pain scoring by Revised Oswestry disability index before and after 1 month of injections, standard X-rays, MRI of the lumbar spine and appropriate CT guided spinal injection was done using a combined solution of anesthetic and long acting steroid. Results: 35% of the patients had low backache with radicular pain, 65% had low back pain with no radicular pain. We performed facet joint injection in 20% of our patients, selective nerve root block in 20%, sacroiliac joint injection in 27.5% of our patients and 32.5% underwent combined injections. The mean value of Revised Oswestry disability index before injections was 27.6 and 16.9 after injections of all patients group. There were overall significant improvement in pain relief as well as physical, occupational and psycho-logical status during 6 months follow-up. Conclusion: CT guided facet joint injection, sacroiliac joint injection, selective nerve root block could be effective modality in management of chronic low back pain and its sequels.