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. Gofeld, M., Tiennot, T., Miller, E., Rebhun, N., Mobley, S., Leblang, S., Aginsky, R., Hananel, A., & Aubry, J. Regional Anesthesia & Pain Medicine, March, 2024. 1 citations (Crossref) [2024-04-25]
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 [link]Paper  doi  abstract   bibtex   
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.
@article{gofeld_fluoroscopy-guided_2024,
	title = {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},
	issn = {1098-7339, 1532-8651},
	shorttitle = {Fluoroscopy-guided high-intensity focused ultrasound ablation of the lumbar medial branch nerves},
	url = {https://rapm.bmj.com/lookup/doi/10.1136/rapm-2024-105417},
	doi = {10.1136/rapm-2024-105417},
	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.},
	language = {en},
	urldate = {2024-04-22},
	journal = {Regional Anesthesia \& Pain Medicine},
	author = {Gofeld, Michael and Tiennot, Thomas and Miller, Eric and Rebhun, Niv and Mobley, Stephen and Leblang, Suzanne and Aginsky, Ron and Hananel, Arik and Aubry, Jean-Francois},
	month = mar,
	year = {2024},
	note = {1 citations (Crossref) [2024-04-25]},
	pages = {rapm--2024--105417},
}

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