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.
Reg Anesth Pain Med
; 2024 Mar 20.
Article
en En
| MEDLINE
| ID: mdl-38508592
ABSTRACT
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.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Idioma:
En
Revista:
Reg Anesth Pain Med
/
Reg. anesth. pain med
/
Regional anesthesia and pain medicine
Asunto de la revista:
ANESTESIOLOGIA
/
NEUROLOGIA
/
PSICOFISIOLOGIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Canadá