Comparison of two ultrasound-guided injection techniques targeting the sacroiliac joint region in equine cadavers.

The research compares two ultrasound-guided injection methods used to guide injections into equine sacroiliac joints and investigates the accuracy, distribution, safety, and effectiveness of these.

Objective

The research aimed to compare and evaluate the efficacy and accuracy of two ultrasound-guided injections targeting the sacroiliac joint region in horse cadavers.

Methodology

• The researchers used 10 lumbosacropelvic specimens for this study.
• Both sacroiliac joints of the specimens were injected through two different methods – the cranial parasagittal (CR) approach, and the caudomedial (CM) approach.
• The CR method used curved 18 gauge, 25 cm spinal needles, and the CM approach used straight 18 gauge, 15 cm spinal needles.
• The injectate consisted of 4 ml of iodinated contrast and 2 ml of methylene blue.
• Researchers performed CT scans before and after the injections to capture the distribution of the injectate.
• They also recorded the time taken to guide and reposition the needles.

Results

• The study observed that intra-articular contrast could be detected following just under half of the injections (15 out of 40).
• Both CR and CM approaches resulted in the injectate being deposited within 2 cm of the sacroiliac joint margins.
• The injectate touched the interosseous sacroiliac ligaments frequently, as well as other neurovascular and synovial structures nearby, implying potential for unwanted spread.
• However, the CR injections also resulted in contact with the lumbosacral intertransverse joints 15 out of 20 times.
• Caudomedial injections often resulted in perivascular distribution, implying they may have been closer to large blood vessels, which happened 16 out of 20 times.

Conclusions

• Through the assessment, it was found that both injection methods had high accuracy for periarticular injection but proved to be less precise for intra-articular injection.
• The overall safety and effectiveness of these two methods could not be definitively established by this study.
• The study concludes that more research is needed to better understand and compare these two injection methods and possibly enhance their accuracy and safety.