Fluoroscopy-guided high-intensity focused ultrasound ablation of the lumbar medial branch nerves : dose escalation study and comparison with radiofrequency ablation in a porcine model
© American Society of Regional Anesthesia & Pain Medicine 2024. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ..
BACKGROUND: Radiofrequency ablation (RFA) is a common method for alleviating chronic back pain by targeting and ablating of facet joint sensory nerves. High-intensity focused ultrasound (HIFU) is an emerging, non-invasive, image-guided technology capable of providing thermal tissue ablation. While HIFU shows promise as a potentially superior option for ablating sensory nerves, its efficacy needs validation and comparison with existing methods.
METHODS: Nine adult pigs underwent fluoroscopy-guided HIFU ablation of eight lumbar medial branch nerves, with varying acoustic energy levels: 1000 (N=3), 1500 (N=3), or 2000 (N=3) joules (J). An additional three animals underwent standard RFA (two 90 s long lesions at 80°C) of the same eight nerves. Following 2 days of neurobehavioral observation, all 12 animals were sacrificed. The targeted tissue was excised and subjected to macropathology and micropathology, with a primary focus on the medial branch nerves.
RESULTS: The percentage of ablated nerves with HIFU was 71%, 86%, and 96% for 1000 J, 1500 J, and 2000 J, respectively. In contrast, RFA achieved a 50% ablation rate. No significant adverse events occurred during the procedure or follow-up period.
CONCLUSIONS: These findings suggest that HIFU may be more effective than RFA in inducing thermal necrosis of the nerve.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Regional anesthesia and pain medicine - (2024) vom: 20. März |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Gofeld, Michael [VerfasserIn] |
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| Links: |
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| Themen: |
Animal Experimentation |
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| Anmerkungen: |
Date Revised 20.03.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1136/rapm-2024-105417 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM369981758 |
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| 100 | 1 | |a Gofeld, Michael |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Fluoroscopy-guided high-intensity focused ultrasound ablation of the lumbar medial branch nerves |b dose escalation study and comparison with radiofrequency ablation in a porcine model |
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| 500 | |a Citation Status Publisher | ||
| 520 | |a © American Society of Regional Anesthesia & Pain Medicine 2024. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ. | ||
| 520 | |a BACKGROUND: Radiofrequency ablation (RFA) is a common method for alleviating chronic back pain by targeting and ablating of facet joint sensory nerves. High-intensity focused ultrasound (HIFU) is an emerging, non-invasive, image-guided technology capable of providing thermal tissue ablation. While HIFU shows promise as a potentially superior option for ablating sensory nerves, its efficacy needs validation and comparison with existing methods | ||
| 520 | |a METHODS: Nine adult pigs underwent fluoroscopy-guided HIFU ablation of eight lumbar medial branch nerves, with varying acoustic energy levels: 1000 (N=3), 1500 (N=3), or 2000 (N=3) joules (J). An additional three animals underwent standard RFA (two 90 s long lesions at 80°C) of the same eight nerves. Following 2 days of neurobehavioral observation, all 12 animals were sacrificed. The targeted tissue was excised and subjected to macropathology and micropathology, with a primary focus on the medial branch nerves | ||
| 520 | |a RESULTS: The percentage of ablated nerves with HIFU was 71%, 86%, and 96% for 1000 J, 1500 J, and 2000 J, respectively. In contrast, RFA achieved a 50% ablation rate. No significant adverse events occurred during the procedure or follow-up period | ||
| 520 | |a CONCLUSIONS: These findings suggest that HIFU may be more effective than RFA in inducing thermal necrosis of the nerve | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Animal Experimentation | |
| 650 | 4 | |a Back Pain | |
| 650 | 4 | |a Methods | |
| 650 | 4 | |a Pain Management | |
| 650 | 4 | |a TECHNOLOGY | |
| 700 | 1 | |a Tiennot, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Miller, Eric |e verfasserin |4 aut | |
| 700 | 1 | |a Rebhun, Niv |e verfasserin |4 aut | |
| 700 | 1 | |a Mobley, Stephen |e verfasserin |4 aut | |
| 700 | 1 | |a Leblang, Suzanne |e verfasserin |4 aut | |
| 700 | 1 | |a Aginsky, Ron |e verfasserin |4 aut | |
| 700 | 1 | |a Hananel, Arik |e verfasserin |4 aut | |
| 700 | 1 | |a Aubry, Jean-Francois |e verfasserin |4 aut | |
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