Magnetic resonance-guided focused ultrasound treatment of facet joint pain: summary of preclinical phase
| Autor: | Arik Hanannel, Itay Goor-Aryeh, Osnat Dogadkin, Zion Zibly, Lilach Shay, Sagi Harnof, Yael Inbar, Israel Caspi |
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| Rok vydání: | 2014 |
| Předmět: |
musculoskeletal diseases
Facet (geometry) medicine.medical_specialty Pain palliation medicine.medical_treatment Chronic back pain Imaging phantom Facet joint medicine Back pain Radiology Nuclear Medicine and imaging medicine.diagnostic_test MRgFUS ExAblate business.industry Research Ultrasound Facet joints Magnetic resonance imaging musculoskeletal system Ablation medicine.anatomical_structure Radiology medicine.symptom business Biomedical engineering |
| Zdroj: | Journal of Therapeutic Ultrasound |
| ISSN: | 2050-5736 |
| DOI: | 10.1186/2050-5736-2-9 |
| Popis: | Study design A phantom experiment, two thermocouple experiments, three in vivo pig experiments, and a simulated treatment on a healthy human volunteer were conducted to test the feasibility, safety, and efficacy of magnetic resonance-guided focused ultrasound (MRgFUS) for treating facet joint pain. Objective The goal of the current study was to develop a novel method for accurate and safe noninvasive facet joint ablation using MRgFUS. Summary of background data Facet joints are a common source of chronic back pain. Direct facet joint interventions include medial branch nerve ablation and intra-articular injections, which are widely used, but limited in the short and long term. MRgFUS is a breakthrough technology that enables accurate delivery of high-intensity focused ultrasound energy to create a localized temperature rise for tissue ablation, using MR guidance for treatment planning and real-time feedback. Methods We validated the feasibility, safety, and efficacy of MRgFUS for facet joint ablation using the ExAblate 2000® System (InSightec Ltd., Tirat Carmel, Israel) and confirmed the system's ability to ablate the edge of the facet joint and all terminal nerves innervating the joint. A phantom experiment, two thermocouple experiments, three in vivo pig experiments, and a simulated treatment on a healthy human volunteer were conducted. Results The experiments showed that targeting the facet joint with energies of 150–450 J provides controlled and accurate heating at the facet joint edge without penetration to the vertebral body, spinal canal, or root foramina. Treating with reduced diameter of the acoustic beam is recommended since a narrower beam improves access to the targeted areas. Conclusions MRgFUS can safely and effectively target and ablate the facet joint. These results are highly significant, given that this is the first study to demonstrate the potential of MRgFUS to treat facet joint pain. |
| Databáze: | OpenAIRE |
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