MRI-Guided and CT-Guided Cervical Nerve Root Infiltration Therapy: A Cost Comparison

• Published in: RöFo : Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebende Verfahren Vol. 186; no. 6; pp. 559 - 566
• Main Authors: Maurer, M. H., Froeling, V., Röttgen, R., Bretschneider, T., Hartwig, T., Disch, A. C., de Bucourt, M., Hamm, B., Streitparth, F.
• Format: Journal Article
• Language: English
• Published: Stuttgart · New York Georg Thieme Verlag KG 01.06.2014
• Subjects: Adult; Aged; Anti-Inflammatory Agents - administration & dosage; Costs and Cost Analysis; Female; Fluoroscopy - economics; Germany; Health Policy; Humans; Injections, Spinal - economics; Magnetic Resonance Imaging, Interventional - economics; Male; Middle Aged; National Health Programs - economics; Radiculopathy - drug therapy; Radiculopathy - economics; Radiography, Interventional - economics; Spinal Nerve Roots - drug effects; Tomography, X-Ray Computed - economics; Triamcinolone Acetonide - administration & dosage; Germany; nerve root infiltration; CT fluoroscopy; cost analysis; MRI fluoroscopy; health economics
• ISSN: 1438-9029; 1438-9010
• DOI: 10.1055/s-0033-1356169

Abstract Purpose: To evaluate and compare the costs of MRI-guided and CT-guided cervical nerve root infiltration for the minimally invasive treatment of radicular neck pain. Materials and Methods: Between September 2009 and April 2012, 22 patients (9 men, 13 women; mean age: 48.2 years) underwent MRI-guided (1.0 Tesla, Panorama HFO, Philips) single-site periradicular cervical nerve root infiltration with 40 mg triamcinolone acetonide. A further 64 patients (34 men, 30 women; mean age: 50.3 years) were treated under CT fluoroscopic guidance (Somatom Definition 64, Siemens). The mean overall costs were calculated as the sum of the prorated costs of equipment use (purchase, depreciation, maintenance, and energy costs), personnel costs and expenditure for disposables that were identified for MRI- and CT-guided procedures. Additionally, the cost of ultrasound guidance was calculated. Results: The mean intervention time was 24.9 min. (range: 12 – 36 min.) for MRI-guided infiltration and 19.7 min. (range: 5 – 54 min.) for CT-guided infiltration. The average total costs per patient were EUR 240 for MRI-guided interventions and EUR 124 for CT-guided interventions. These were (MRI/CT guidance) EUR 150/60 for equipment use, EUR 46/40 for personnel, and EUR 44/25 for disposables. The mean overall cost of ultrasound guidance was EUR 76. Conclusion: Cervical nerve root infiltration using MRI guidance is still about twice as expensive as infiltration using CT guidance. However, since it does not involve radiation exposure for patients and personnel, MRI-guided nerve root infiltration may become a promising alternative to the CT-guided procedure, especially since a further price decrease is expected for MRI devices and MR-compatible disposables. In contrast, ultrasound remains the less expensive method for nerve root infiltration guidance. Citation Format: • Maurer MH, Froeling V, Röttgen R et al. MRI-Guided and CT-Guided Cervical Nerve Root Infiltration Therapy: A Cost Comparison. Fortschr Röntgenstr 2014; 186: 559 – 566