Sumen Ahmet, Kurt Oktay Kubra Neslihan
BAM Clinic of Physical Medicine and Rehabilitation, Istanbul, Turkey.
Department of Physical Medicine and Rehabilitation, University of Health Sciences, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
Eur Spine J. 2025 Apr;34(4):1552-1561. doi: 10.1007/s00586-025-08705-3. Epub 2025 Feb 6.
This study aimed to evaluate the applicability and technical feasibility of magnetic resonance imaging (MRI) and ultrasonography (US) fusion-guided transforaminal epidural steroid injection (TFESI) in patients with lumbar disc herniation (LDH) leading to radiculopathy, who are unresponsive to conservative treatment.
This retrospective study included 21 patients aged 18-65 years who underwent MRI-US fusion-guided TFESI for LDH-induced radiculopathy. Patient data, including demographic characteristics, body mass index (BMI), fluoroscopy duration, radiation dose, and procedure success, were analyzed. Success was defined by the contrast-spread pattern during the procedure. Statistical analyses were performed to identify factors predicting procedural success.
The MRI-US fusion-guided TFESI procedure was successful in 81% of patients. Successful outcomes were significantly associated with younger age (≤ 56 years, p < 0.001), lower BMI (≤ 28 kg/m², p < 0.001), shorter fluoroscopy duration (> 4.9 s, p < 0.001), and lower radiation dose (> 3.7 mGy, p < 0.001). A positive correlation was observed between age and radiation dose (p = 0.030), as well as between BMI and radiation dose (p = 0.049).
MRI-US fusion-guided TFESI is a feasible and safe technique with a high success rate and low radiation exposure in patients with LDH-induced radiculopathy. Younger age, lower BMI, shorter fluoroscopy duration, and lower radiation dose are significant predictors of procedural success. This technique may enhance spatial orientation during the procedure, potentially improving outcomes particularly in younger patients with lower BMI.
本研究旨在评估磁共振成像（MRI）与超声（US）融合引导下经椎间孔硬膜外类固醇注射（TFESI）在对保守治疗无反应的腰椎间盘突出症（LDH）导致神经根病患者中的适用性和技术可行性。
这项回顾性研究纳入了21例年龄在18 - 65岁之间、因LDH引起神经根病而接受MRI-US融合引导下TFESI治疗的患者。分析了患者数据，包括人口统计学特征、体重指数（BMI）、透视时间、辐射剂量和手术成功率。手术成功的定义为术中造影剂扩散模式。进行统计分析以确定预测手术成功的因素。
MRI-US融合引导下的TFESI手术在81%的患者中成功。成功结果与较年轻的年龄（≤56岁，p < 0.001）、较低的BMI（≤28 kg/m²，p < 0.001）、较短的透视时间（> 4.9秒，p < 0.001）和较低的辐射剂量（> 3.7 mGy，p < 0.001）显著相关。年龄与辐射剂量之间（p = 0.030）以及BMI与辐射剂量之间（p = 0.049）观察到正相关。
MRI-US融合引导下的TFESI是一种可行且安全的技术，对于LDH引起神经根病的患者成功率高且辐射暴露低。较年轻的年龄、较低的BMI、较短的透视时间和较低的辐射剂量是手术成功的重要预测因素。该技术可能会增强手术过程中的空间定位，尤其可能改善BMI较低的年轻患者的治疗效果。
