Minimally Invasive Magnetic Resonance Imaging-Guided Free-Hand Aspiration of Symptomatic Nerve Route Compressing Lumbosacral Cysts Using a 1.0-Tesla Open Magnetic Resonance Imaging System

Abstract

To evaluate the feasibility of minimally invasive magnetic resonance imaging (MRI)-guided free-hand aspiration of symptomatic nerve route compressing lumbosacral cysts in a 1.0-Tesla (T) open MRI system using a tailored interactive sequence. Eleven patients with MRI-evident symptomatic cysts in the lumbosacral region and possible nerve route compressing character were referred to a 1.0-T open MRI system. For MRI interventional cyst aspiration, an interactive sequence was used, allowing for near real-time position validation of the needle in any desired three-dimensional plane. Seven of 11 cysts in the lumbosacral region were successfully aspirated (average 10.1mm [SD±1.9]). After successful cyst aspiration, each patient reported speedy relief of initial symptoms. Average cyst size was 9.6mm (±2.6mm). Four cysts (8.8±3.8mm) could not be aspirated. Open MRI systems with tailored interactive sequences have great potential for cyst aspiration in the lumbosacral region. The authors perceive major advantages of the MR-guided cyst aspiration in its minimally invasive character compared to direct and open surgical options along with consecutive less trauma, less stress, and also less side-effects for the patient.