scholarly journals Magnetic resonance imaging-guided lumbar nerve root infiltrations: optimization of an in-house protocol

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Max Scheffler ◽  
Pauline Coralie Guillemin ◽  
Orane Lorton ◽  
Enrique Maturana ◽  
Nicolas Lauper ◽  
...  
Keyword(s):  
Nerve Root ◽  
Radiation Risk ◽  
Radicular Pain ◽  
Surface Coil ◽  
Technical Note ◽  
Mr Images ◽  
Iodinated Contrast Medium ◽  
Mri Guidance ◽  
Iodinated Contrast ◽  
Lumbar Nerve Root

Abstract Background For the treatment of radicular pain, nerve root infiltrations can be performed under MRI guidance in select, typically younger, patients where repeated CT exams are not desirable due to associated radiation risk, or potential allergic reactions to iodinated contrast medium. Methods Fifteen 3 T MRI-guided nerve root infiltrations were performed in 12 patients with a dedicated surface coil combined with the standard spine coil, using a breathhold PD sequence. The needle artifact on the MR images and the distance between the needle tip and the infiltrated nerve root were measured. Results The distance between the needle tip and the nerve root was 2.1 ± 1.4 mm. The visual artifact width, perpendicular to the needle long axis, was 2.1 ± 0.7 mm. No adverse events were reported. Conclusion This technical note describes the optimization of the procedure in a 3 T magnetic field, including reported procedure time and an assessment of targeting precision.

Nerve root anomalies: implications for transforaminal lumbar interbody fusion surgery and a review of the Neidre and Macnab classification system

2013 ◽  
Vol 35 (2) ◽  
pp. E9 ◽  
Author(s):  
Shane M. Burke ◽  
Mina G. Safain ◽  
James Kryzanski ◽  
Ron I. Riesenburger
Keyword(s):  
Nerve Root ◽  
Classification System ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Radicular Pain ◽  
Neurogenic Claudication ◽  
Lumbar Interbody Fusion ◽  
Lumbar Nerve Root ◽  
History Of ◽  
Mini Open

Lumbar nerve root anomalies are uncommon phenomena that must be recognized to avoid neural injury during surgery. The authors describe 2 cases of nerve root anomalies encountered during mini-open transforaminal lumbar interbody fusion (TLIF) surgery. One anomaly was a confluent variant not previously classified; the authors suggest that this variant be reflected in an amendment to the Neidre and Macnab classification system. They also propose strategies for identifying these anomalies and avoiding injury to anomalous nerve roots during TLIF surgery. Case 1 involved a 68-year-old woman with a 2-year history of neurogenic claudication. An MR image demonstrated L4–5 stenosis and spondylolisthesis and an L-4 nerve root that appeared unusually low in the neural foramen. During a mini-open TLIF procedure, a nerve root anomaly was seen. Six months after surgery this patient was free of neurogenic claudication. Case 2 involved a 60-year-old woman with a 1-year history of left L-4 radicular pain. Both MR and CT images demonstrated severe left L-4 foraminal stenosis and focal scoliosis. Before surgery, a nerve root anomaly was not detected, but during a unilateral mini-open TLIF procedure, a confluent nerve root was identified. Two years after surgery, this patient was free of radicular pain.

scholarly journals Contrast-Induced Encephalopathy after Cerebral Angiogram: A Case Series and Review of Literature

2021 ◽  
pp. 405-413
Author(s):  
Cecelia Allison ◽  
Vaibhav Sharma ◽  
Jason Park ◽  
Clemens M. Schirmer ◽  
Ramin Zand
Keyword(s):  
Rare Complication ◽  
General Pattern ◽  
Treatment Protocol ◽  
Case Series ◽  
Altered Mental Status ◽  
Cortical Blindness ◽  
Neurological Deficits ◽  
Cerebral Angiogram ◽  
Iodinated Contrast Medium ◽  
Iodinated Contrast

Contrast-induced encephalopathy (CIE) is a rare complication that arises from exposure to iodinated contrast medium and can result in a range of symptoms, including cortical blindness, aphasia, focal neurological deficits, and altered mental status. We present 4 individual cases of CIE who presented with stroke-mimic symptoms following surgery with localized iodixanol or ioversol injection. We outline a clinical timeline of all patients, showing that CIE follows a general pattern of delayed onset, worsening symptomology, and ultimately full recovery. All patients received IV hydration, corticosteroids, or both as part of their treatment protocol.

Central Venous Catheter Integrity during Mechanical Power Injection of Iodinated Contrast Medium

Radiology ◽  
2009 ◽  
Vol 253 (3) ◽  
pp. 870-878 ◽  
Author(s):  
Douglas B. Macha ◽  
Rendon C. Nelson ◽  
Laurens E. Howle ◽  
John W. Hollingsworth ◽  
Sebastian T. Schindera
Keyword(s):  
Central Venous Catheter ◽  
Contrast Medium ◽  
Venous Catheter ◽  
Mechanical Power ◽  
Central Venous ◽  
Iodinated Contrast Medium ◽  
Iodinated Contrast ◽  
Power Injection
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