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European Radiology
Published in: European Radiology 12/2013

01-12-2013 | Interventional

MR-guided facet joint injection therapy using an open 1.0-T MRI system: an outcome study

Authors: Patrick Freyhardt, Tony Hartwig, Maximilian De Bucourt, Martin Maurer, Diane Renz, Bernhard Gebauer, Bernd Hamm, Ulf K. M. Teichgräber, Florian Streitparth

Published in: European Radiology | Issue 12/2013

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Abstract

Objectives

To evaluate the accuracy, safety and efficacy of magnetic resonance imaging (MRI)-guided facet joint injection therapy using a 1.0-T open MRI.

Methods

One hundred and sixty-six facet joint blocks in 45 patients with lower back pain were performed under MR fluoroscopic guidance using a proton-density-weighted turbo-spin-echo sequence. An in-room monitor, wireless MR-mouse for operator-controlled multiplanar navigation, a flexible surface coil and MR-compatible 20-G needle were used. Clinical outcome was evaluated by questionnaire before intervention and after 1 week, 3, 6 and 12 months using a numerical visual analogue scale (VAS).

Results

All facet joint blocks were considered technically successful with distribution of the injectant within and/or around the targeted facet joint. No major complications occurred. The final outcome analysis included 38 patients. An immediate effect was reported by 63 % of the patients. A positive mid-/long-term effect was seen in 13 patients (34 %) after 6 months and in 9 patients (24 %) after 12 months. Mean VAS was reduced from 7.1 ± 1.7 (baseline) to 3.5 ± 2.2, 4.1 ± 3.0, 3.8 ± 2.9 and 4.6 ± 2.9 at 1 week, 3, 6 and 12 months (P < 0.01).

Conclusions

MR-guided facet joint injection therapy of the lumbosacral spine is accurate, safe and efficient in the symptomatic treatment of lower back pain.

Key Points

• MR-guided facet joint infiltration provides an alternative to CT and conventional fluoroscopy.
• Clinical outcomes are comparable with conventional fluoroscopy and CT-guided facet joint interventions.
• Ionising radiation can be avoided for both patient and physician.
• MR-guided facet joint injection provides safe and effective treatment of back pain.
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Metadata
Title
MR-guided facet joint injection therapy using an open 1.0-T MRI system: an outcome study
Authors
Patrick Freyhardt
Tony Hartwig
Maximilian De Bucourt
Martin Maurer
Diane Renz
Bernhard Gebauer
Bernd Hamm
Ulf K. M. Teichgräber
Florian Streitparth
Publication date
01-12-2013
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-013-2940-9

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