Department of Anaesthesia and Pain Medicine, St Mary's Hospital, Imperial College Healthcare NHS Trust, Praed Street, London, W2 1NY, UK.
Eur Radiol. 2012 Dec;22(12):2822-35. doi: 10.1007/s00330-012-2628-6. Epub 2012 Aug 31.
To evaluate the safety and efficacy of magnetic resonance-guided focused ultrasound (MRgFUS) to treat facet joint osteoarthritis pain.
Patients with a positive response to facet joint interventions were recruited from Pain and Spinal Clinics. Treatments were performed at the levels of pain according to symptomatology, previous invasive treatment and MRI grading of facet joint osteoarthritis. Both safety and efficacy data were collected. Pain palliation was evaluated using a validated pain numerical rating scale (NRS), Oswestry disability questionnaire (ODQ), Brief Pain Inventory (BPI) and the EuroQol (EQ-5D) health state score
Eighteen patients were treated. There were no major adverse events. At 6/12 we found a reduction in both the NRS (average/worst) pain scores (60.2 %/51.2 %). This was associated with 45.9 % improvement in the ODQ score and 61.9 % reduction in the BPI interference score. We observed an improvement in the EuroQol (EQ-5D) health state score based on UK coefficients of +0.379 (0.317 to 0.696).
Our phase I observational pilot study has evaluated an innovative new technique that is both non-invasive and radiation free. It is the first description of this procedure in the literature. In all patients the technique was safe, free of complications, effective and well tolerated.
Magnetic resonance-guided focused ultrasound offers non-invasive therapy for facet joint pain. MRgFUS appears to be an effective and safe thermal ablation technique for facet joint pain. Real-time image control and thermal feedback minimise complications. MRgFUS allows outpatient management of facet joint osteoarthritic low back pain.
评估磁共振引导聚焦超声（MRgFUS）治疗关节突关节骨关节炎疼痛的安全性和有效性。
从疼痛和脊柱诊所招募对关节突关节介入有阳性反应的患者。根据症状、先前的侵入性治疗和关节突关节骨关节炎的 MRI 分级，在疼痛部位进行治疗。收集安全性和疗效数据。使用经过验证的疼痛数字评分量表（NRS）、Oswestry 残疾问卷（ODQ）、简明疼痛量表（BPI）和欧洲五维健康量表（EQ-5D）健康状况评分评估疼痛缓解情况。
18 名患者接受了治疗。没有发生重大不良事件。在 6/12 个月时，我们发现 NRS（平均/最差）疼痛评分均降低（60.2%/51.2%）。这与 ODQ 评分提高 45.9%和 BPI 干扰评分降低 61.9%相关。我们观察到基于英国系数的 EQ-5D 健康状况评分改善为+0.379（0.317 至 0.696）。
我们的 I 期观察性试点研究评估了一种新型的非侵入性和无辐射创新技术。这是该程序在文献中的首次描述。在所有患者中，该技术安全、无并发症、有效且耐受性良好。
磁共振引导聚焦超声为关节突关节疼痛提供了非侵入性治疗。MRgFUS 似乎是一种有效且安全的热消融技术，适用于关节突关节疼痛。实时图像控制和热反馈可最大程度地减少并发症。MRgFUS 允许门诊管理关节突关节骨关节炎性下腰痛。
