title: Cost comparison of nerve root infiltration of the lumbar spine under MRI and CT guidance.
abstract: OBJECTIVE
  To compare the costs of CT- and MR-guided lumbosacral nerve root infiltration for minimally invasive treatment of low back pain and radicular pain.
  
  
  METHODS
  Ninety patients (54 men, 36 women; mean age, 45.5 ± 12.8 years) underwent MR-guided single-site periradicular lumbosacral nerve root infiltration with 40 mg of triamcinolone acetonide. A further 91 patients (48 men, 43 women; mean age, 59.1 ± 13.8 years) were treated under CT fluoroscopy guidance. Prorated costs of equipment use (purchase, depreciation and maintenance), staff costs based on involvement times and expenditure for disposables were identified for MR- and CT-guided procedures.
  
  
  RESULTS
  Mean intervention time was 20.6 min (14-30 min) for MR-guided and 14.3 min (7-32 min) for CT-guided treatment. The average total costs per patient were €177 for MR-guided and €88 for CT-guided interventions. These consisted of (MR/CT guidance) €93/29 for equipment use, €43/35 for staff and €41/24 for disposables.
  
  
  CONCLUSIONS
  Lumbosacral nerve root infiltration using MRI guidance is still about twice as expensive as infiltration using CT guidance. Given the advantages of no radiation exposure and possible future decrease in prices for MRI devices and MR-compatible injection needles, MR-guided nerve root infiltration may become a promising alternative to the CT-guided procedure.
  
  
  CONCLUSIONS
  • MR-guided nerve root infiltration therapy is now technically and clinically established. • Costs using MRI guidance are still about double those for CT guidance. • MR guidance involves no radiation exposure to patients and personnel. • MR-guided nerve root infiltration may become a promising alternative to CT.
authors: Department of Radiology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. martin.maurer@charite.de
authors: M H
authors: MH
authors: Maurer
authors: N
authors: N
authors: Schreiter
authors: M
authors: M
authors: de Bucourt
authors: C
authors: C
authors: Grieser
authors: D M
authors: DM
authors: Renz
authors: T
authors: T
authors: Hartwig
authors: B
authors: B
authors: Hamm
authors: F
authors: F
authors: Streitparth
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005471:Fluoroscopy / Q000191:economics*; D005858:Germany; D017048:Health Care Costs; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000191:economics; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000191:economics*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013126:Spinal Nerve Roots / Q000000981:diagnostic imaging / Q000473:pathology*; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000191:economics*; D055815:Young Adult