The in vivo pain treatment was successfully performed with the patient in a prone position. The PD‐weighted TSE with echo time = 10 ms rendered contrast‐to‐noise‐ratio values of 27 ± 10 for needle/fat, 1.6 ± 5 for needle/muscle, and 4 ± 4.7 for needle/nerve tissue. The mean diameter of the needle artifact was 1.2 ± 0.2 mm. In the T1‐weighted gradient echo, the needle's artifact diameter was 6 ± 2 mm; the needle's contrast‐to‐noise ratio relative to muscle tissue was 4 ± 2, 7.6 ± 1.5 for needle/fat, and 5 ± 1 for needle/nerve tissue. With the PD‐weighted TSE (echo time = 10 ms) and the T1‐weighted gradient echo, the needle was imaged reliably throughout the intervention. The butterfly surface coil is feasible for the guidance of spinal interventions in a prone patient. Magn Reson Med, 2012. © 2011 Wiley Periodicals, Inc.