Sperling Medical Group

reading & research

Don’t Miss This Video on MRgFUS for Facet Joint Pain!

If you enjoy movies, you probably have a favorite category. You may prefer drama, suspense, action, romance, comedy, or sci-fi. Some people really go for documentaries. However, for pure entertainment, there’s nothing like a 12-minute educational presentation! (Okay, I’m partly joking.)

Seriously, though, some lecturers are better at capturing audience attention than others, even when the content is academic and technical. I came across a video presentation on the use of MRI-guided Focused Ultrasound (MRgFUS) to treat chronic low back pain due to facet joint arthritis.

The presenter, Wladyslaw “Wady” Gedroyc, MD is a Consultant Radiologist at London’s St. Mary’s Hospital, Imperial College NHS. Despite his Eastern European-sounding name, he is a delightful speaker whose British accent makes him sound like a cast member of Downton Abbey. He gave his talk during the 1st European Symposium on Focused Ultrasound Therapy (Sep. 22-23, 2011), which was organized by the Sapienza University of Rome. Over 200 professionals attended, evidence of the robust interest in MRgFUS, especially in Europe at that time, where research and development enjoyed a “tremendous amount of government funding,” according to one observer.1

MRgFUS for lower back pain – key points

MRgFUS is a noninvasive treatment that uses focused “beams” of ultrasound (sonic energy) aimed at a target in the body. They come from several different directions, passing harmlessly through intervening tissue. When they converge (intersect) on the target, they generate lethal heat that can precisely destroy the target. Currently, MRgFUS can be applied to treat uterine fibroids, prostate cancer, metastatic bone tumors, brain tumors, tremors due to Parkinson’s disease and Essential Tremor, and chronic back pain from facet joint arthritis in the spine.

Dr. Gedroyc makes many points in his lecture, and despite technical terms, I think it’s easy to understand why MRgFUS is such an elegant treatment for facet joint pain. I highly recommend watching “MR Guided Facet Ablation for Chronic Back Pain” (it may take a minute to load, so be patient). However, if you don’t have time to watch all 12 minutes, here are the key points:

  1. Chronic low back pain doesn’t have just one cause. It involves multiple coexisting disease processes: bone degeneration, nerve compression, and facet joint cartilage erosion (arthritis).
  2. For diagnosing facet joint pain, the current “gold standard” is a positive response to a local anesthetic injected into either the facet joint.
  3. Current treatments for facet joint pain include oral medications, image-guided numbing and steroid injections, and radiofrequency denervation (disabling the nerve, also called rhizotomy).
  4. It’s very easy to use Focused Ultrasound (FUS) to disable the pain-messaging nerve.
  5. The presentation includes a description of a clinical trial with 19 patients diagnosed with facet joint pain, and details of the procedure itself.
  6. Clinical trial results: significant reduction in lower back pain using the Numerical Rating Score. For average pain, 62.3% reduction at 6 months; for worst pain, 57.9% reduction. Also, disabilities due to pain were improved.
  7. There was little to no pain during the procedure, and there were no side effects or complications, thanks to real-time imaging and thermal feedback, which gave the ability to verify accuracy of the expected therapeutic effect.

MRgFUS at the Sperling Medical Group

Our center, the Sperling Medical Group, offers MRgFUS to treat facet joint arthritis. Our state-of-the-art 3 Tesla magnet is integrated with a focused ultrasound delivery system and the advanced software needed to identify the source of the pain, plan treatment, and use thermal monitoring to assure accuracy and effectiveness.

For more information about this safe and successful treatment for facet joint pain, contact the Sperling Medical Group.


Facet Pain