title: Outcome study of real-time MR-guided cervical periradicular injection therapy in an open 1.0 Tesla MRI system.
abstract: OBJECTIVE
  To evaluate the accuracy, safety, and efficacy of cervical nerve root injection therapy using magnetic resonance guidance in an open 1.0 T MRI system.
  
  
  METHODS
  Between September 2009 and April 2012, a total of 21 patients (9 men, 12 women; mean age 47.1 ± 11.1 years) underwent MR-guided cervical periradicular injection for cervical radicular pain in an open 1.0 T system. An interactive proton density-weighted turbo spin echo (PDw TSE) sequence was used for real-time guidance of the MR-compatible 20-gauge injection needle. Clinical outcome was evaluated on a verbal numeric rating scale (VNRS) before injection therapy (baseline) and at 1 week and 1, 3, and 6 months during follow-up.
  
  
  RESULTS
  All procedures were technically successful and there were no major complications. The mean preinterventional VNRS score was 7.42 and exhibited a statistically significant decrease (P < 0.001) at all follow-up time points: 3.86 ± 1.53 at 1 week, 3.21 ± 2.19 at 1 month, 2.58 ± 2.54 at 3 months, and 2.76 ± 2.63 at 6 months. At 6 months, 14.3 % of the patients reported complete resolution of radicular pain and 38.1 % each had either significant (4-8 VNRS score points) or mild (1-3 VNRS score points) relief of pain; 9.5 % experienced no pain relief.
  
  
  CONCLUSIONS
  Magnetic resonance fluoroscopy-guided periradicular cervical spine injection is an accurate, safe, and efficacious treatment option for patients with cervical radicular pain. The technique may be a promising alternative to fluoroscopy- or CT-guided injections of the cervical spine, especially in young patients and in patients requiring repeat injections.
authors.affiliation: Department of Radiology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany, martin.maurer@charite.de.
authors.forename: Martin H
authors.initials: MH
authors.lastname: Maurer
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Disch
authors.forename: Tony
authors.initials: T
authors.lastname: Hartwig
authors.forename: Diane M
authors.initials: DM
authors.lastname: Renz
authors.forename: Nils
authors.initials: N
authors.lastname: Schreiter
authors.forename: B
authors.initials: B
authors.lastname: Hamm
authors.forename: Florian
authors.initials: F
authors.lastname: Streitparth
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage*; D000777:Anesthetics / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D053783:Magnetic Resonance Imaging, Interventional / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000188:drug therapy*; D010147:Pain Measurement; D011446:Prospective Studies; D011843:Radiculopathy / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D000777:Anesthetics