Nerve root infiltration of the first sacral root with MRI guidance

J Magn Reson Imaging. 2000 Oct;12(4):556-61. doi: 10.1002/1522-2586(200010)12:4<556::aid-jmri6>3.0.co;2-c.

Abstract

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.

Publication types

  • Clinical Trial

MeSH terms

  • Bupivacaine / administration & dosage
  • Contrast Media
  • Humans
  • Intervertebral Disc Displacement / therapy*
  • Lumbosacral Plexus*
  • Magnetic Resonance Imaging* / methods
  • Methylprednisolone / administration & dosage
  • Middle Aged
  • Sciatica / therapy*
  • Sodium Chloride
  • Treatment Outcome

Substances

  • Contrast Media
  • Sodium Chloride
  • Methylprednisolone
  • Bupivacaine