title: MRI-guided focused ultrasound ablation of lumbar medial branch nerve: Feasibility and safety study in a swine model.
abstract: About 10-40% of chronic low back pain cases involve facet joints, which are commonly treated with lumbar medial branch (MB) radiofrequency neurotomy. Magnetic resonance imaging-guided focused ultrasound (MRgFUS), a non-invasive, non-ionising ablation modality used to treat tumours, neuropathic pain and painful bone metastasis can also be used to disrupt nerve conduction. This work's purpose was to study the feasibility and safety of direct MRgFUS ablation of the lumbar MB nerve in acute and subacute swine models.
  
  
  
  In vivo MRgFUS ablation was performed in six swine (three acute and three subacute) using a clinical MRgFUS system and a 3-T MRI scanner combination. Behavioural assessment was performed, and imaging and histology were used to assess the treatment.
  
  
  
  Histological analysis of the in vivo studies confirmed thermal necrosis of the MB nerve could be achieved without damaging the spinal cord or adjacent nerve roots. MRgFUS did not cause changes in the animals' behaviour or ambulation.
authors.affiliation: a Department of Medical Physics , Memorial Sloan Kettering Cancer Center , New York ;
authors.forename: Elena A
authors.initials: EA
authors.lastname: Kaye
authors.affiliation: b Tri-Institutional Laboratory of Comparative Pathology, Memorial Sloan Kettering Cancer Center , Rockefeller University, Weill Cornell Medical College , New York ;
authors.forename: Sebastien
authors.initials: S
authors.lastname: Monette
authors.affiliation: c Department of Radiology , Memorial Sloan Kettering Cancer Center , New York ;
authors.forename: Govindarajan
authors.initials: G
authors.lastname: Srimathveeravalli
authors.affiliation: c Department of Radiology , Memorial Sloan Kettering Cancer Center , New York ;
authors.forename: Majid
authors.initials: M
authors.lastname: Maybody
authors.affiliation: c Department of Radiology , Memorial Sloan Kettering Cancer Center , New York ;
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Solomon
authors.affiliation: d Department of Anesthesiology , Memorial Sloan Kettering Cancer Center , New York , USA.
authors.forename: Amitabh
authors.initials: A
authors.lastname: Gulati
mesh_terms: D000818:Animals; D002417:Cattle; D004195:Disease Models, Animal; D005240:Feasibility Studies; D005260:Female; D057086:High-Intensity Focused Ultrasound Ablation / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009407:Nerve Block / Q000379:methods*
keywords: FUS; Facet joint; HIFU; MRI-guided; nerve ablation; swine model