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MR guidance and thermometry of percutaneous laser disc decompression in open MRI: an initial clinical investigation.
- Source :
-
European Radiology . Oct2013, Vol. 23 Issue 10, p2739-2746. 8p. 1 Color Photograph, 2 Black and White Photographs, 3 Charts. - Publication Year :
- 2013
-
Abstract
- Objectives: To assess the feasibility, safety and efficacy of real-time MR guidance and thermometry of percutaneous laser disc decompression (PLDD). Methods: Twenty-four discs in 22 patients with chronic low-back and radicular pain were treated by PLDD using open 1.0-T magnetic-resonance imaging (MRI). A fluoroscopic proton-density-weighted turbo spin-echo (PDw TSE) sequence was used to position the laser fibre. Non-spoiled gradient-echo (GRE) sequences were employed for real-time thermal monitoring based on proton resonance frequency (PRF). Radicular pain was assessed over 6 months with a numerical rating scale (NRS). Results: PLDD was technically successful in all cases, with adequate image quality for laser positioning. The PRF-based real-time temperature monitoring was found to be feasible in practice. After 6 months, 21 % reported complete remission of radicular pain, 63 % at least great pain relief and 74 % at least mild relief. We found a significant decrease in the NRS score between the pre-intervention and the 6-month follow-up assessment ( P < 0.001). No major complications occurred; the single adverse event recorded, moderate motor impairment, resolved. Conclusions: Real-time MR guidance and PRF-based thermometry of PLDD in the lumbar spine under open 1.0-T MRI appears feasible, safe and effective and may pave the way to more precise operating procedures. Key Points: • Percutaneous laser disc decompression ( PLDD) is increasingly used instead of conventional surgery. • Open 1. 0- T MRI with temperature mapping seems technically successful in monitoring PLDD. • Pain relief was at least ' great' in 64 % of patients. • No major complications occurred. • Open 1. 0- T MRI appears a safe and effective option for patient- tailored PLDD. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 09387994
- Volume :
- 23
- Issue :
- 10
- Database :
- Academic Search Index
- Journal :
- European Radiology
- Publication Type :
- Academic Journal
- Accession number :
- 90169448
- Full Text :
- https://doi.org/10.1007/s00330-013-2872-4