Skeletal Radiology

, Volume 42, Issue 4, pp 579–586

High-resolution magnetic resonance-guided posterior femoral cutaneous nerve blocks

  • Jan Fritz
  • Cary Bizzell
  • Sudhir Kathuria
  • Aaron J. Flammang
  • Eric H. Williams
  • Allan J. Belzberg
  • John A. Carrino
  • Avneesh Chhabra
Technical Report

DOI: 10.1007/s00256-012-1553-8

Cite this article as:
Fritz, J., Bizzell, C., Kathuria, S. et al. Skeletal Radiol (2013) 42: 579. doi:10.1007/s00256-012-1553-8

Abstract

Objective

To assess the feasibility, technical success, and effectiveness of high-resolution magnetic resonance (MR)-guided posterior femoral cutaneous nerve (PFCN) blocks.

Materials and methods

A retrospective analysis of 12 posterior femoral cutaneous nerve blocks in 8 patients [6 (75 %) female, 2 (25 %) male; mean age, 47 years; range, 42–84 years] with chronic perineal pain suggesting PFCN neuropathy was performed. Procedures were performed with a clinical wide-bore 1.5-T MR imaging system. High-resolution MR imaging was utilized for visualization and targeting of the PFCN. Commercially available, MR-compatible 20-G needles were used for drug delivery. Variables assessed were technical success (defined as injectant surrounding the targeted PFCN on post-intervention MR images) effectiveness, (defined as post-interventional regional anesthesia of the target area innervation downstream from the posterior femoral cutaneous nerve block), rate of complications, and length of procedure time.

Results

MR-guided PFCN injections were technically successful in 12/12 cases (100 %) with uniform perineural distribution of the injectant. All blocks were effective and resulted in post-interventional regional anesthesia of the expected areas (12/12, 100 %). No complications occurred during the procedure or during follow-up. The average total procedure time was 45 min (30–70) min.

Conclusions

Our initial results demonstrate that this technique of selective MR-guided PFCN blocks is feasible and suggest high technical success and effectiveness. Larger studies are needed to confirm our initial results.

Copyright information

© ISS 2012

Authors and Affiliations

  • Jan Fritz
    • 1
    • 5
  • Cary Bizzell
    • 1
  • Sudhir Kathuria
    • 1
  • Aaron J. Flammang
    • 2
  • Eric H. Williams
    • 3
    • 6
  • Allan J. Belzberg
    • 4
  • John A. Carrino
    • 1
  • Avneesh Chhabra
    • 1
  1. 1.Russell H. Morgan Department of Radiology and Radiological ScienceThe Johns Hopkins University School of MedicineBaltimoreUSA
  2. 2.Siemens Corporate ResearchCenter for Applied Medical ImagingBaltimoreUSA
  3. 3.Department of Plastic, Reconstructive, and Maxillofacial SurgeryThe Johns Hopkins University School of MedicineBaltimoreUSA
  4. 4.Department of NeurosurgeryThe Johns Hopkins University School of MedicineBaltimoreUSA
  5. 5.Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological ScienceJohns Hopkins University School of MedicineBaltimoreUSA
  6. 6.Dellon Institute for Peripheral Nerve SurgeryTowsonUSA