Ultrasound Sonoanatomy and Associated Interventional Procedures for Axial Structures

David A. Provenzano, M.D.
Executive Director
Institute for Pain Diagnostics and Care
Ohio Valley General Hospital
500 Pine Hollow Road
McKees Rocks, PA 15136

Introduction - TOP

Recently, there has been significant interest in the utilization of ultrasound for chronic pain management procedures. Traditional visualization techniques for these procedures include fluoroscopy and computed tomography (CT). With fluoroscopic guided procedures the initial extrapolation of the position of soft tissues (i.e. muscles, blood vessels, and nerves) is based on their anatomic relationship to viewed bony structures. The interest in the use of ultrasound for chronic pain management procedures has grown from certain visualization advantages including the ability to see muscle layers, nerves, and blood vessels (Table 1).1 Ultrasound allows for the elimination or reduction of radiation exposure for both the patient and physician. Additionally, real time needle advancement can be visualized with ultrasound. Limitations to current ultrasound technology exist, including narrow image windows, and acoustic shadow artifact which results in the inability to view structures deep to bony obstruction.

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