Ultrasound is an imaging technique based on the emission and reception of ultrasound waves by a probe. It is mainly used as a diagnostic procedure and to guide needle insertion in different medical fields (radiology, cardiology, gynaecology, etc.). The excellent ultrasound imaging of anatomical structures in the musculoskeletal system have made new techniques possible that were previously available.
Surgical techniques are traditionally performed using fluoroscopy (X-ray). However, fluoroscopy has potentially harmful effects for patients and healthcare personnel, and specific facilities are also required. Conversely, ultrasound is non-toxic, and it can be used during a visit to the doctor as it does not require specialised facilities. Unlike fluoroscopy, ultrasound also enables us to visualise blood vessels, muscles, fasciae and some cavities or spaces, which are often where the pain that we want to treat originates. Ultrasound also offers a wider range of diagnostic possibilities through the location of joint effusions, muscle and tendon fibre tears, arthrosis, cysts and inflammatory processes.
We must remember that fluoroscopy displays bony structures only, and contrast radiography is required to visualise soft tissues.
Surgery is recommended to treat chronic pain when the conservative treatments of pharmacological therapy and rehabilitation have been ineffective.
The structure we want to treat is identified using ultrasound, which offers the following advantages:
Accurate work without the need for X-rays.
The needle and the injection of the drug into our target can be observed in real time.
Accurate identification of joints, and superficial and underlying muscles to be treated, as well as neighbouring, visceral (pleura, kidneys) and vascular structures, enabling the muscle to be blocked with greater safety.
In the field of spinal pathology, ultrasound can be used to guide treatment of: