Background/Introduction: Back pain is an extremely common symptom with
between 54% and 80% of patients suffering sometime in their life, and it is estimated that
facet related pain accounts for up to 50% of these problems. Current therapy for facet
disease consists of all pain medication and localized injections all radiofrequency ablation’s
of facet joints facet rhizotomies.
This study has attempted to explore whether MR guided focused ultrasound, which is
noninvasive, can be used to carry out facet joint ablations and therefore improve pain
and disability from this condition.
Methods: We have recruited 16 patients from the pain and spinal clinics who have had
previous positive successful facet joint interventions and have now presented with recurrent
similar pain. Focused ultrasound was applied to the facet joints on both sides at the
level of pain and at a level above and level below the site of maximum pain.
Results & Conclusions: The range of motion of the system is 10 x 10 x 10 cm with a
spatial precision of 0.3 mm. A variety of sonication patterns are possible including single
point, multi-point, and scanned exposures. The system has been tested and functions on
MR scanners from all major vendors, at both 1.5 and 3 T. In addition, the entire system
is portable and can be transported between the laboratory and MRI for in-bore and
benchtop experiments. This turnkey research platform is intended to lower the technology
barrier that exists for groups to engage in MRI-guided focused ultrasound research.
Acknowledgements (Funding): Results are provided in terms of pain using visual
analog scores and disability using the Oswestry disability index. The mean improvement
in pain index was 62.3%, and the mean improvement in the disability index at six months
These results show a very promising response to this innovative type of therapy and
suggest that further investigation of this technique is warranted to see if this could
replace interventional procedures for the treatment of facet associated back pain.