Devoted to diagnostic and interventional spine imaging and therapeutics

Library

The Use of Gadolinium-Based Contrast Agents in Spine Interventions 2004

Fuchs, Yonathan, Dickson, Asante, M.D., Ortiz, Orlando, MD, MBA, Zee, Chi-Shing, MD, Wagner, Andrew, M.D.

Patients with a history of renal insufficiency or severe allergic reaction to iodinated contrast material have benefited from the use of gadolinium-based contrast agents for angiographic diagnostic and interventional procedures. These successful applications have served as a basis for expanding the use of gadolinium-based contrast agents in other clinical settings. The use of an alternative contrast agent such as gadolinium may represent an appropriate strategy in the management of patients with back pain who have contraindicat ions to iodine-based contrast agents.

We report our experience with the use of a gadolinium contrast agent in spine interventions including discography, epidurography, selective nerve root blocks, and facet injection. A total of 13 procedures were performed (5 discographies, 5 epidurographies, 2 peri-neurographies, and one facet arthrogram). Visualization of the gadolinium contrast agent with all imaging modalities including fluoroscopy, CT and MRI, was excellent in all cases. No contrast agent related complications occurred.

Gadolinium is a safe, viable alternative to the conventional iodine contrast agents that are routinely used in spine interventional procedures. Its use may be considered in patients precluded from undergoing spine intervention due to iodinated contrast allergy or renal azotemia.