Role of Ultrasonography in Paraspinal and Nerve Root Evaluation

This chapter discusses the expanding role of musculoskeletal ultrasonography (MSK-USG) in the evaluation and management of spinal disorders. Low back pain, neck pain, and radicular syndromes are among the most common reasons for orthopedic consultation, necessitating accurate imaging for diagnosis and treatment planning. While conventional imaging such as radiographs, computed tomography, and magnetic resonance imaging remain foundational, ultrasound offers unique advantages, including radiation-free real-time dynamic imaging and portability. MSK-USG enables detailed assessment of paraspinal muscles, fascial planes, and superficial bony landmarks and allows visualization of exiting nerve roots in the cervical and lumbar regions. Its utility extends to guiding interventional procedures such as nerve root blocks, facet injections, and trigger point injections with improved safety and precision. Additionally, ultrasound provides functional insights through dynamic assessment of muscle activation and nerve mobility. Although operator dependency and limited deep intraspinal visualization remain constraints, MSK-USG’s role as a complementary modality in spine care is increasingly recognized.