Magnetic resonance neurography in chronic lumbosacral and pelvic pain: Diagnostic and management impact- Institutional audit.

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Magnetic resonance neurography in chronic lumbosacral and pelvic pain: Diagnostic and management impact- Institutional audit.

World Neurosurg. 2018 Mar 23;:

Authors: Dessouky R, Xi Y, Scott KM, Khaleel M, Gill K, Jones S, Khalifa DN, Tantawy HI, Aidaros MA, Chhabra A

Abstract
BACKGROUND: / purpose: Low back and pelvic pain are among the most prevalent conditions worldwide, with major social and economic costs. The aim of this study was to evaluate the role of Magnetic Resonance Neurography (MRN) of lumbosacral plexus in the management and outcomes of these chronic pain patients.
METHODS: Consecutive patients with chronic lumbosacral and pelvic pain referred for MRN over a year were included. Pre-and post-imaging clinical diagnosis and treatment, pain levels and location were recorded. Pain free survival was compared between treatments using Cox proportional hazards model.
RESULTS: 202 patients with mean age 53.7± 14.8 years, and male to female ratio 1:1.53 were included. 115 patients presented with radiculopathy (57%), 56 with pelvic pain (28%) and 31 with groin pain (15%). Mean initial pain level was 6.9 ± 1.9. Mean symptom duration was 4.21 ± 5.86 years. 143 (71%) of patients had a change in management due to MRN. Post MRN, reduction in pain levels was observed in (21/32, 66%) of patients receiving conservative; (42/67, 63%) injection; and (27/33, 82%) surgery. Follow ups were available in 131 patients. Median pain-free survival was 12 months. Patients treated with surgery had significantly lower pain recurrence than other treatments in the same time frame (hazard ratio 3.6, 95% CI 1.4-9.2, p = 0.0061).
CONCLUSION: MRN use in chronic lumbosacral and pelvic pain lead to a meaningful change in diagnosis and treatment. Following MRN, conservative treatment and injections provided pain relief, however, patients benefited more from surgery than any other treatment.

PMID: 29581014 [PubMed - as supplied by publisher]

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