MR imaging-guided lumbosacral spinal injection procedures

Jan Fritz, Roberto B. Sequeiros, John A. Carrino

Research output: Contribution to journalArticle

Abstract

Magnetic resonance (MR)-guided spinal injection procedures describe techniques for percutaneous drug delivery procedures in which MR imaging is used for visualization of the anatomic target, for accurate image-guided needle placement, monitoring of the injectant, and for visualization of the distribution and unintended spread of the injectant to adjacent spinal structures. Initially performed with open low-field MR imaging systems, the recent introduction of clinical wide-bore MR imaging systems has contributed to increased availability and improved practicability of MR-guided spine injections. Field strength of 1.5 T, modern coil technology, and parallel imaging techniques afford increased MR signal, which can be utilized for faster temporal resolution, higher spatial resolution, improved contrast resolution, and combinations thereof. The unparalleled contrast resolution of MR imaging provides the interventionalist with osseous and soft-tissue detail for excellent visualization of spinal targets and injectants. Because interventional MR imaging obviates patients and staff exposure to ionizing radiation, it exemplarily complies with the practice mandate to maintain exposures to ionizing radiation as low as reasonably achievable (ALARA principle) and complements X-ray fluoroscopy and computed tomography guidance. In this article, we review pertinent principles of MR imaging-guided spine injections and illustrate MR guidance techniques for lumbosacral spinal injection procedures, including sacroiliac joint injections, facet joint injections, median branch blocks, perineural and transforaminal injections, interlaminar epidural injections, sympathetic injections, and celiac plexus injections.

Original languageEnglish (US)
Pages (from-to)78-89
Number of pages12
JournalTechniques in Orthopaedics
Volume28
Issue number1
DOIs
StatePublished - Mar 2013

Fingerprint

Spinal Injections
Magnetic Resonance Imaging
Injections
Magnetic Resonance Spectroscopy
Ionizing Radiation
Spine
Interventional Magnetic Resonance Imaging
Celiac Plexus
Epidural Injections
Zygapophyseal Joint
Sacroiliac Joint
X Ray Computed Tomography
Fluoroscopy
Needles
Technology
Pharmaceutical Preparations

Keywords

  • discography
  • epidural injection
  • facet joint injection
  • interventional MR imaging
  • median branch block
  • MR-guided
  • MRI guidance
  • nerve block
  • sacroiliac joint injection
  • spine injection

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

MR imaging-guided lumbosacral spinal injection procedures. / Fritz, Jan; Sequeiros, Roberto B.; Carrino, John A.

In: Techniques in Orthopaedics, Vol. 28, No. 1, 03.2013, p. 78-89.

Research output: Contribution to journalArticle

Fritz, Jan ; Sequeiros, Roberto B. ; Carrino, John A. / MR imaging-guided lumbosacral spinal injection procedures. In: Techniques in Orthopaedics. 2013 ; Vol. 28, No. 1. pp. 78-89.
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