Value of applying real-time ultrasound guidance combined with CT monitoring in cervical intervertebral disc puncture

English Keywords:Real-time ultrasound-guided  Cervical discogenic dizziness  CT monitoring  Cervical intervertebral disc puncture

English Abstract:

  【Abstract】 Objectives: To explore the application value of real-time ultrasound guidance combined with CT monitoring in cervical disc puncture. Methods: From January 2023 to February 2024, a total of 60 patients presenting with chronic cervical pain and refractory dizziness, who had not experienced any improvement despite at least one year of various conservative treatments and were suspected of having cervical discogenic vertigo, were enrolled, including 28 males and 32 females, aged 26-67 years(47.0±10.5 years). Utilizing a random number allocation principle, the patients were divided into two groups of 30 cases each. One group underwent cervical disc puncture performed by an ultrasonographer with over 5 years of musculoskeletal interventional experience using real-time ultrasound guidance combined with CT monitoring, while the other group received simple CT-guided cervical disc puncture performed by spine surgeons. Baseline data were collected of the two groups of patients, including age, gender, body mass index(BMI), heart rate, systolic and diastolic blood pressure. Puncture guidance parameters were compared such as preoperative positioning time, total puncture time, and CT exposures. Complications were also compared between groups. SPSS 26.0 statistical software was used to analyze and compare the above mentioned data. Results: There were no significant differences in age, gender ratio, BMI, heart rate, systolic and diastolic blood pressure between the two groups (P>0.05). All 60 patients successfully underwent cervical intervertebral disc punctures targeting the C4/5(10 cases), C5/6(44 cases), and C6/7(6 cases) segments. Ultrasound-guided CT monitoring group exhibited shorter preoperative positioning time than CT guidance alone group[3.5(3.0, 4.3)min vs 5.0(4.8, 6.0)min], the difference was statistically significant(P＜0.001). However, ultrasound-guided CT monitoring group demonstrated significantly shorter total puncture time[9.0(8.8, 11.0)min vs 15.0(14.0, 17.0)min] and fewer CT exposures[9.0(8.8, 11.0) vs 15.0(14.0, 17.0)] compared to CT guidance alone group(P<0.001). 2 cases in the CT guidance alone group occurred hematoma, while none such complication occurred in the ultrasound guided CT monitoring group. Conclusions: Real-time ultrasound-guided cervical intervertebral disc puncture combined with CT monitoring is a novel, rapid, safe, and effective approach that has certain clinical values.