Ultrasound-guided zygapophysial nerve and joint injection

Diagnostic and therapeutic lumbar zygapophysial (facet) nerve and joint interventions are probably the most commonly performed injections in pain management, and routine fluoroscopy guidance is required. Imaging is necessary to ensure precise needle position and to exclude an intravascular injection. Because the procedure is considered a low-risk intervention, use of ultrasound (US) guidance is thought to be an attractive alternative to fluoroscopy mainly because the former renders no ionizing radiation to the patient and medical personnel. In addition US-guided procedures are essentially “office-based” and do not require a radiology suite or operating room.