Abstract
BackgroundFor the treatment of radicular pain, nerve root infiltrations can be performed under MRI guidance in select, typically younger, patients where repeated CT exams are not desirable due to associated radiation risk, or potential allergic reactions to iodinated contrast medium.MethodsFifteen 3 T MRI-guided nerve root infiltrations were performed in 12 patients with a dedicated surface coil combined with the standard spine coil, using a breathhold PD sequence. The needle artifact on the MR images and the distance between the needle tip and the infiltrated nerve root were measured.ResultsThe distance between the needle tip and the nerve root was 2.1 ± 1.4 mm. The visual artifact width, perpendicular to the needle long axis, was 2.1 ± 0.7 mm. No adverse events were reported.ConclusionThis technical note describes the optimization of the procedure in a 3 T magnetic field, including reported procedure time and an assessment of targeting precision.
Highlights
For the treatment of radicular pain, nerve root infiltrations can be performed under Magnetic resonance imaging (MRI) guidance in select, typically younger, patients where repeated computed tomography (CT) exams are not desirable due to associated radiation risk, or potential allergic reactions to iodinated contrast medium
If the operator opts for an injection of iodinated contrast medium around the nerve, the patient is exposed to a risk of a contrast-induced allergic reaction, even if a very small amount is used
We describe our MRI-guided infiltration method on a 3 T machine for the treatment of radicular pain
Summary
For the treatment of radicular pain, nerve root infiltrations can be performed under MRI guidance in select, typically younger, patients where repeated CT exams are not desirable due to associated radiation risk, or potential allergic reactions to iodinated contrast medium. The etiology of low back pain is mostly degenerative and multifactorial. It has been estimated that approximately 90% of sciatica, a common form of radicular pain, is due to disc herniation [3]. The age of onset of sciatica may occur earlier than low back pain, with a peak incidence thought to occur in patients in their forties [6]. If the operator opts for an injection of iodinated contrast medium around the nerve, the patient is exposed to a risk of a contrast-induced allergic reaction, even if a very small amount is used.
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