Nerve root infiltration of the first sacral root with MRI guidance.
The purpose of this clinical trial was to describe the methodology and evaluate the accuracy of optical tracking-based magnetic resonance (MR)-guided infiltration of the first sacral (S1) root. Thirty-five infiltrations were performed on 34 patients with a 0. 23-T open C-arm magnet installed in a fully equipped operation room with large-screen (36 inches) display and optical navigator utilizing infrared passive tracking. T1 and T2 fast spin-echo (FSE) images were used for localizing the target and fast field echo for monitoring the procedure. Saline as contrast agent in single-shot (SS)FSE images gave sufficient contrast-to-noise ratio. Twenty-four patients had unoperated L5/S1 disc herniation, and 10 had S1 root irritation after failed back surgery. Needle placement was successful in 97% of the cases, and no complications occurred. Outcome was evaluated 1-6 months (mean 2.2 months) after the procedure and was comparable to that of other studies using fluoroscopy or computed tomography guidance. MR-guided placement of the needle is an accurate technique for first sacral root infiltration.
Ojala
R
R
Department of Radiology, University Hospital of Oulu, 90220 Oulu, Finland. risto.ojala@oulu.fi
Vahala
E
E
Karppinen
J
J
Klemola
R
R
Blanco-Sequeiros
R
R
Vaara
T
T
Tervonen
O
O
D002045:Bupivacaine / Q000008:administration & dosage; D003287:Contrast Media; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000628:therapy*; D008160:Lumbosacral Plexus; D008279:Magnetic Resonance Imaging / Q000379:methods; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D012585:Sciatica / Q000628:therapy*; D012965:Sodium Chloride; D016896:Treatment Outcome
D003287:Contrast Media; D012965:Sodium Chloride; D008775:Methylprednisolone; D002045:Bupivacaine