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Greater occipital nerve infiltration under MR guidance: Feasibility study and preliminary results

  • Interventional
  • Published:
European Radiology Aims and scope Submit manuscript

An Erratum to this article was published on 13 October 2017

This article has been updated

Abstract

Objective

To assess the feasibility of greater occipital nerve (GON) intermediate site infiltration with MRI guidance.

Methods

Eleven consecutive patients suffering from chronic refractory cranio-facial pain who underwent 16 GON infiltrations were included in this prospective study. All of the procedures were performed on an outpatient basis in the research facility of our institution, with a 1.5 T scanner. The fatty space between inferior obliquus and semispinalis muscles at C1-C2 level was defined as the target. Technical success was defined as the ability to accurately inject the products at the target, assessed by post-procedure axial and sagittal proton density-weighted sequences. Clinical success was defined as a 50% pain decrease at 1 month.

Results

Technical success was 100%. GON was depicted in 6/11 cases on planning MRI sequences. Mean duration of procedure was 22.5 min (range 16–41). Clinical success was obtained in 7/11 included patients (63.6%) with a mean self-reported improvement of 78%.

Conclusion

Interventional MR-guidance for GON infiltration is a feasible technique offering similar results to an already established effective procedure. It may appear as a useful tool in specific populations, such as young patients and repeat infiltrations, and should be considered in these settings.

Key Points

• MR guidance for GON infiltration is a feasible technique.

• Preliminary results are in agreement with other guidance modalities.

• MR guidance may be seen as a useful tool in specific populations.

• Specific populations include young patients and repeat infiltrations.

• Target patients may also include patients with potentionally previously reported complications (torticollis).

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Change history

  • 13 October 2017

    The original version of this article, published on 12 July 2017, unfortunately contained mistakes. The following corrections have therefore been made in the original:

Abbreviations

CT:

Computed tomography

GON:

Greater occipital nerve

MRI:

Magnetic resonance imaging

PD:

Proton density

PDI:

Pain Disability Index

SPAIR:

Spectral Attenuated Inversion Recovery

TSE:

Turbo Spin Echo

US:

Ultrasound

VAS:

Visual Analogue Scale

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Acknowledgements

The authors would like to sincerely thank Lilia Langar and Vincent Auboiroux for their help with MR acquisition and sequence development.

Author information

Authors and Affiliations

  1. Neuroradiology and MRI Unit, Grenoble Alpes University Hospital, CS 10217, F-38043, Grenoble Cedex 9, France

    Adrian Kastler, Romain Perolat & Alexandre Krainik

  2. CLINATEC Research Facility, LETI, CEA Grenoble, Grenoble, France

    Adrian Kastler, Romain Perolat, Alim Louis Benabid & Stephan Chabardes

  3. Adult Radiology Department, Necker Hospital, Paris V University, Paris, France

    Bruno Kastler

  4. Pain Management Unit, Grenoble Alpes University Hospital, Grenoble, France

    Caroline Maindet-Dominici

  5. Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Jan Fritz

  6. Neurosurgery Unit, Grenoble Alpes University Hospital, Grenoble, France

    Stephan Chabardes

Authors
  1. Adrian Kastler
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  2. Romain Perolat
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  3. Bruno Kastler
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  4. Caroline Maindet-Dominici
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  5. Jan Fritz
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  8. Alexandre Krainik
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Corresponding author

Correspondence to Adrian Kastler.

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Guarantor

The scientific guarantor of this publication is Alexandre Krainik.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Disclosure

Jan Fritz received institutional research funds and speaker’s honorarium from Siemens AG and is a scientific advisor of Siemens AG and Alexion Pharmaceuticals, Inc.

Funding

The authors state that this work has not received any funding.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• prospective

• observational

• performed at one institution

Additional information

The original version of this article was revised: Figures 2 – 5 were in a wrong position. The correct versions are given below.

An erratum to this article is available at https://doi.org/10.1007/s00330-017-5044-0.

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Kastler, A., Perolat, R., Kastler, B. et al. Greater occipital nerve infiltration under MR guidance: Feasibility study and preliminary results. Eur Radiol 28, 886–893 (2018). https://doi.org/10.1007/s00330-017-4952-3

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  • DOI: https://doi.org/10.1007/s00330-017-4952-3

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