DOI: https://doi.org/10.22141/1608-1706.5.17.2016.83875

Magnetic Resonance Imaging in Planning the Endoscopic Access for Denervation of Lumbar Facet Joints

V.A. Radchenko, V.A. Kutsenko, A.I. Popov, О.V. Perfiliev, A.V. Kulakov

Abstract


The aim of this study is the definition of coordinates of measurements on the basis of magnetic resonance imaging to improve endoscopic access for denervation of the lumbar facet joints. Material and methods. We have analyzed magnetic resonance scans (magnetic field power source 1.5 and 3.0 Tesla) in 13 patients (5 men and 8 women aged from 29 to 78 years, average age — 57.8 years) with osteochondrosis and clinically meaningful facet syndrome of the lumbar spine. The research was conducted in T1, T2, T2fs (fat suppression) modes. Measurements for scheduling access were performed using RadiAnt DICOM Viewer 1.9.16 program. Results of the study. In interfascial zones to perform minimally invasive access in modes T1, T2 and T2fs, the angle of endoscopic tubes in axial projection ranged from 69.4 to 84.3°, and in the sagittal — from 9.2 to 15.7°. Indentation from the top of spinous processes in the transverse direction was from 36 to 57 mm. In 3 patients (23 %) in the axial and coronal projections at the level of segments L4-L5 and L5-S1, medial branches were visualized in the place of their discharge from the spinal nerves, and in 10 patients (77 %) imaging is not clearly defined. Conclusions. Definition of coordinates according to the magnetic resonance imaging using the program RadiAnt DICOM Viewer 1.9.16 on bone markers significantly reduces the time for release of the nerves and prevents additional injury to subjacent soft tissues, and as a method of neuroimaging in certain sections in the axial T2 and coronary T2fs projections, it helps to visualize the medial posterior branches of spinal nerves in the lumbar spine in 23 % of cases.


Keywords


lumbar facet joints; spondylarthritis syndrome; magnetic resonance imaging; minimally invasive access planning; neurovisualization; anatomic variation of nerves

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