19 Harley St, London, W1G 9QJ, UK

Freehand real-time MRI-guided lumbar spinal injection procedures at 1.5 T: feasibility, accuracy, and safety

OBJECTIVE: The purpose of this study was to test the hypothesis that freehand real-time MRI-guided lumbar spinal injection procedures are feasible, accurate, and safe when performed with a clinical open-bore 1.5-T MRI system. MATERIALS AND METHODS: A retrospective analysis was made of spinal injection procedures performed over an 18-month period. Forty-nine procedures were performed on 37 patients (23 women, 14 men; mean age, 36 years; range, 18-48 years). A rapid FLASH 2D MRI sequence (TR/TE, 9.3/3.5; slice thickness, 5 mm; acquisition time, 1 second) was used for real-time needle placement with freehand technique. Data assessed were type of procedure, qualitative and quantitative image quality, dimensions of needle artifact, rate of successful drug delivery, rate of vascular uptake, time requirements, and occurrence of complications. RESULTS: Among the 49 procedures, 22 (45%) were nerve root injections, 18 (37%) were facet joint injections, and nine (18%) were epidural injections. The quality of real-time FLASH 2D MR images was sufficient in all cases. Contrast-to-noise ratios were sufficiently high for good delineation of relevant structures. The needle artifact made was remarkably constant with an average overestimation of length of 1.0 +/- 0.2 [SD] mm. Drug delivery was successful in all selective nerve root injections and epidural injections. The rate of successful drug delivery was 89% (16 of 18) for facet joint injections. No complete intravascular injections occurred. The mean table time was 36 minutes (range, 23-75 minutes). The mean real-time MRI time was 38 seconds (range, 12-185 seconds). No major complications occurred. CONCLUSION: We accept the hypothesis that freehand real-time MRI-guided lumbar spinal injection procedures are feasible, accurate, and safe when performed with a clinical open-bore 1.5-T MRI system. We note that real-time MRI guidance has the additional advantage of a complete absence of patient and operator exposure to ionizing radiation

Keywords : Adolescent,Adult,Analysis of Variance,complications,Contrast Media,Feasibility Studies,Female,Humans,Injections,Spinal,Lumbar Vertebrae,Magnetic Resonance Imaging,Interventional,Male,methods,Middle Aged,Radiology,Retrospective Studies,Safety,, Realtime,Mriguided,Lumbar,Spinal,Injection, breast reduction pain how long does it last

Date of Publication : 2009 Apr

Authors : Fritz J;Thomas C;Clasen S;Claussen CD;Lewin JS;Pereira PL;

Organisation : Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 N Wolfe St., Baltimore, MD 21287, USA. jan.fritz@gmx.net

Journal of Publication : AJR Am J Roentgenol

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/19304676

The London Spine Unit : Harley Street UK. Specialists in Cutting Edge Technologies for Spinal Surgery

Make an Appointment 

Trustpilot Reviews
Doctify Reviews
Top Doctor Reviews

Freehand real-time MRI-guided lumbar spinal injection procedures at 15 T feasibility, accuracy, and safety | Cervical disc replacement surgery - Hashem al-ghaili - facebook

What our patients say ...

Consultant Spine Surgeon
Consultant Spine Surgeon
Consultant Spine Surgeon

This surgical technique consists of a percutaneous approach for the treatment of small to medium size hernias of the intervertebral disc by laser energy. The main objective is to reduce the intradiscal pressure in the nucleus pulposus

Laser Disc Surgery can be performed under local anaesthetic as a day case at our centre on the prestigious Harley Street.
What is London spine unit and How it Works

The London Spine Unit was established in 2005 and has successfully treated over 5000 patients. All conditions are treated.

treatment of all spinal disorders

The London Spine Unit specialises in Minimally Invasive Treatments allowing rapid recovery and return to normal function

Trusted by patients worldwide

The London Spine Unit provides the highest quality care to all patients and has VIP services for those seeking exceptional services

If you have any emergency Doctor’s need, simply call our 24 hour emergency

Your personal case manager will ensure that you receive the best possible care.

Call Now 

+44 844 589 2020
+44 203 973 8810