Clinical outcomes of 3T magnetic resonance imaging-guided lumbar and sacral foraminal injections.

Autor: Guillemin PC; Faculty of Medicine, University of Geneva, Geneva, Switzerland. Pauline.guillemin@unige.ch., Salomir R; Faculty of Medicine, University of Geneva, Geneva, Switzerland.; Division of Radiology, Geneva University Hospitals, Geneva, Switzerland., Lauper N; Division of Orthopedic Surgery and Traumatology, Geneva University Hospitals, Geneva, Switzerland., Lorton O; Faculty of Medicine, University of Geneva, Geneva, Switzerland., Maturana E; Division of Radiology, Geneva University Hospitals, Thônex, Switzerland., Stöckli A; Division of Radiology, Geneva University Hospitals, Thônex, Switzerland., Poletti PA; Division of Radiology, Geneva University Hospitals, Geneva, Switzerland., Dominguez DE; Division of Orthopedic Surgery and Traumatology, Geneva University Hospitals, Geneva, Switzerland., Boudabbous S; Division of Radiology, Geneva University Hospitals, Geneva, Switzerland., Scheffler M; Division of Radiology, Geneva University Hospitals, Thônex, Switzerland.
Jazyk: angličtina
Zdroj: Neuroradiology [Neuroradiology] 2023 Dec; Vol. 65 (12), pp. 1793-1802. Date of Electronic Publication: 2023 Oct 17.
DOI: 10.1007/s00234-023-03234-6
Abstrakt: Purpose: This article evaluates the feasibility, safety, and efficacy of MRI-guided lumbar or sacral nerve root infiltration for chronic back pain. We compared the outcomes of our MRI-guided infiltrations with data from CT-guided infiltrations reported in the literature and explored the potential advantages of MRI guidance.
Method: Forty-eight MRI-guided nerve root infiltrations were performed using a 3 T MRI machine. The optimal needle path was determined using breathhold T2-weighted sequences, and the needle was advanced under interleaved guidance based on breathhold PD-weighted images. Pain levels were assessed using a numeric rating scale (NRS) before the procedure and up to 5 months after, during follow-up. Procedure success was evaluated by comparing patients' pain levels before and after the infiltration.
Results: The MRI-guided infiltrations yielded pain reduction 1 week after the infiltration in 92% of cases, with an average NRS substantial change of 3.9 points. Pain reduction persisted after 5 months for 51% of procedures. No procedure-related complications occurred. The use of a 22G needle and reconstructed subtraction images from T2 FatSat sequences improved the workflow.
Conclusion: Our study showed that MRI-guided nerve root infiltration is a feasible, safe, and effective treatment option for chronic back pain. Precise positioning of the needle tip and accurate distribution of the injected solution contributed to the effectiveness of MRI-guided infiltration, which appeared to be as accurate as CT-guided procedures. Further research is needed to explore the potential benefits of metal artifact reduction sequences to optimize chronic back pain management.
(© 2023. The Author(s).)
Databáze: MEDLINE
Externí odkaz: