• Patrick Freyhardt, Tony Hartwig, Maximilian De Bucourt, Martin Maurer, Diane Renz, Bernhard Gebauer, Bernd Hamm, Ulf K M Teichgräber, and Florian Streitparth.
• Charité Universitätsmedizin Berlin, Department of Radiology, Augustenburger Platz 1, 13353, Berlin, Germany, patrick.freyhardt@charite.de.
• Eur Radiol. 2013 Dec 1; 23 (12): 3296-303.

ObjectivesTo evaluate the accuracy, safety and efficacy of magnetic resonance imaging (MRI)-guided facet joint injection therapy using a 1.0-T open MRI.MethodsOne hundred and sixty-six facet joint blocks in 45 patients with lower back pain were performed under MR fluoroscopic guidance using a proton-density-weighted turbo-spin-echo sequence. An in-room monitor, wireless MR-mouse for operator-controlled multiplanar navigation, a flexible surface coil and MR-compatible 20-G needle were used. Clinical outcome was evaluated by questionnaire before intervention and after 1 week, 3, 6 and 12 months using a numerical visual analogue scale (VAS).ResultsAll facet joint blocks were considered technically successful with distribution of the injectant within and/or around the targeted facet joint. No major complications occurred. The final outcome analysis included 38 patients. An immediate effect was reported by 63 % of the patients. A positive mid-/long-term effect was seen in 13 patients (34 %) after 6 months and in 9 patients (24 %) after 12 months. Mean VAS was reduced from 7.1 ± 1.7 (baseline) to 3.5 ± 2.2, 4.1 ± 3.0, 3.8 ± 2.9 and 4.6 ± 2.9 at 1 week, 3, 6 and 12 months (P < 0.01).ConclusionsMR-guided facet joint injection therapy of the lumbosacral spine is accurate, safe and efficient in the symptomatic treatment of lower back pain.

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