A New MRI Technique for Peripheral Nerve Detection and Delineation - Specifically the Genicular Sensory Nerves Around the Knee


Assaf Dekel 1 Anat Grinfeld 2 Yehuda Fridman 3
1Orthopedic, Assuta Medical Center, Israel
2R & D, TPM LTD, Israel
3Radiology, Assuta Medical Center, Israel

Genicualr ablation / block is a growing trend as a clinical solution for chronic pain in osteoarthritic knees (ref. 1). Much like facet block in the spine, it denervates the sensory branch and relieves pain for several months to 2 years (refernce2).

Efficacy of genicular ablation varies, mostly due to the variations in genicular nerve anatomical locations, as ablation sites are usually chosen by bony land marks, without visualization of the nerves (ref. 1, method).

A new approach for optimized MRI acquisition technique is described, with snap shots of results, enabling visualization of the genicular nerve pathway, thus allowing in the future better placement of ablation instrumentation. The technique can be utilized for other peripheral nerves as small as 1mm in diameter.

References:

Woo-Jong Choi, Seung-Jun Hwang, Jun-Gol Song, Jeong-Gil Leem, Yong-Up Kang, Pyong-Hwan Park, Jin-Woo Shin: Radiofrequency treatment relieves chronic knee osteoarthritis pain: A double-blind randomized controlled trial. PAIN 152 (2011) 481–487
Lee Dellon: Partial Knee Joint Denervation for Knee Pain: A Review. J Sports Med Doping Stud 2015, 5:1
Yasar E, Kesikburun S, Kılıç C, Güzelküçük Ü, Yazar F, Tan AK: Accuracy of Ultrasound-Guided Genicular Nerve Block: A Cadaveric Study. Pain Physician. 2015 Sep-Oct;18(5):E899-904