MR guidance of laser disc decompression: preliminary in vivo experience.
The purpose of this study was to perform percutaneous laser disc decompression (PLDD) under MR guidance in an open configuration 0. 5-T MR system. Following failed conservative treatment for 6 months, eight patients with contained disc herniations were enrolled in the study. Following MR guided introduction of the laser fiber into the targeted disc space, the laser-induced temperature distribution was visualized using a color-coded subtraction technique based on a T1-weighted GRE sequence. In seven patients PLDD could be performed. In all cases laser effects were depicted by MR. In this regard the color-coded technique was found to be superior to conventional magnitude images. Whereas no apparent decrease in the extent of herniation was discovered immediately following PLDD, T2-weighted FSE images showed signal intensity alterations in two of the seven patients. Clinical evaluation, obtained 3-4 months after PLDD, revealed a fair (n = 2) or good (n = 4) response to the treatment. One patient showed no change in symptoms. MR guidance and monitoring of PLDD is feasible within an open 0.5-T system and seems to render PLDD more safe and controllable.
Steiner
P
P
Department of Diagnostic Radiology, MR-Center University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland.
Zweifel
K
K
Botnar
R
R
Schoenenberger
A W
AW
Debatin
J F
JF
von Schulthess
G K
GK
Hodler
J
J
D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000601:surgery*; D053685:Laser Therapy / Q000379:methods*; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012449:Safety; D016896:Treatment Outcome