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Related Experiment Videos

MR-guided lumbar sympathicolysis.

Claudius W König1, Ulrich G Schott, Philippe L Pereira

  • 1Department of Diagnostic Radiology, University of Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen, Germany. claudius.koenig@t-online.de

European Radiology
|June 4, 2002
PubMed
Summary

MR-guided lumbar sympathicolysis (LSL) is feasible for various patients, offering a safe alternative to CT guidance. This technique minimizes radiation exposure, making it suitable for repeated procedures.

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Area of Science:

  • Radiology
  • Interventional Radiology
  • Pain Management

Background:

  • Lumbar sympathicolysis (LSL) is a procedure to manage chronic pain.
  • Computed tomography (CT) is commonly used for guidance, but involves radiation exposure.
  • Magnetic resonance (MR) imaging offers potential for guidance without ionizing radiation.

Purpose of the Study:

  • To assess the feasibility of MR-guided lumbar sympathicolysis (LSL) in a general patient population.
  • To evaluate the safety and efficiency of MR-guided LSL.
  • To compare MR guidance with traditional CT guidance for LSL procedures.

Main Methods:

  • One hundred one MR-guided LSL procedures were performed in 89 patients using a 0.2 T open MR system.
  • Gradient-recalled sequences (FISP, fast low-angle shot) were used for needle guidance.

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  • Bupivacaine injection was monitored with MR fluoroscopy; fluid distribution was confirmed with CT in 65 patients.

    • Main Results:

    • Ninety-one (90%) LSL procedures were successfully completed.
    • Ten patients (10%) were not treated due to patient inconvenience or technical challenges (motion artifacts, spondylophytes, hematoma).
    • One case of ureteral necrosis occurred; motion artifacts were less severe with single-slice FISP sequences.

    Conclusions:

    • MR-guided LSL is a feasible procedure with acceptable safety and time efficiency.
    • It is recommended for repeated sympathetic blockades to avoid cumulative radiation from CT.
    • Further research may optimize MR guidance techniques to mitigate challenges like motion artifacts.