- Last Updated: December 13, 2016
Facet arthritis affects the joints that connect the vertebrae and provide stability and flexibility in the spine. It is the source of pain in 15% to 45% of patients suffering from chronic back pain.
Facet arthritis usually develops from normal wear and tear over the lifetime. Factors that increase the risk for facet arthritis include older age, obesity, female gender, trauma to the bones, and work or sports injuries.
Treatment options for facet arthritis include oral medications, injections, and radiofrequency ablation to relieve pain. Surgery can be performed in severe cases.
Focused Ultrasound Treatment
Focused ultrasound may offer a noninvasive, radiation-free method of facet rhizotomy. Using MRI or ultrasound imaging, the physician directs ultrasound beams through the patient’s skin to the sensory nerve along the affected facet joint. This heats and destroys the nerve, thereby blocking its ability to transmit pain signals. As a noninvasive form of facet rhizotomy, focused ultrasound may offer benefits including:
- no needles (anticoagulation thus not an issue)
- no ionizing radiation
- can treat several affected facet joints in one session
- real-time anatomic and thermal monitoring, which reduces the risk for complications
- shorter recovery time.
A phase I observational pilot study of 18 patients with lumbar facet disease was performed at St. Mary's Hospital in London, where focused ultrasound reduced pain and improved quality of life with few side effects. The results of the pilot study were published in 2012. Several patients with facet arthritis pain also have been treated with focused ultrasound at the Kochi Medical University Hospital in Japan. There are other sites in Europe now performing this procedure regularly with good outcomes including patient improvement and few side effects.
A study is underway at Stanford University in California to determine the safety and efficacy of focused ultrasound for lumbar back pain. If you are interested in taking part, please contact Kara Richardson (650.561.5237 or ).
Research and Treatment Sites
MR Therapy Centre at St. Mary’s Hospital, London, United Kingdom
Dr. Gedroyc Wladyslaw
+44 (0) 203 312 7605
Jaslok Hospital and Research Center, Mumbai, India
Dr. Shrinivas B. Desai
+91 22 6657 3368
Concept Medicare (India) Pvt Ltd
Mr. S. Pattu, Chairman
Noble Marine Towers No. 62
Mount Road, Guindy
Chennai, 600 032
Phone: 044 900 2400
Kochi Medical University Hospital, Kochi, Japan
Dr. Motohiro Kawasaki (Orthopaedics)
Phone: 088 880 2386
Future Medical Imaging Group, Melbourne, Australia
Dr. Andrew Dobrotwir Siobhan
+61 2 9818 7833
MRgFUS Center Frankfurt, Germany
Contact Information: Professor Dr. Markus Düx
Regulatory Approval and Reimbursement
The ExAblate system manufactured by InSightec is approved in Europe for treatment of facet arthritis pain. At present, focused ultrasound treatment of facet arthritis pain is not universally reimbursed by medical insurers.
Krug R, Do L, Rieke V, Wilson MW, Saeed M. Evaluation of MRI protocols for the assessment of lumbar facet joints after MR-guided focused ultrasound treatment. J Ther Ultrasound. 2016 Apr 6;4:14. doi: 10.1186/s40349-016-0057-8. eCollection 2016.
Filippiadis DK, Kelekis A. A review of percutaneous techniques for low back pain and neuralgia: current trends in epidural infiltrations, intervertebral disk and facet joint therapies. Br J Radiol. 2016;89(1057):20150357. doi: 10.1259/bjr.20150357. Epub 2015 Oct 14.
Weeks EM, Platt MW, Gedroyc W. MRI-guided focused ultrasound (MRgFUS) to treat facet joint osteoarthritis low back pain-case series of an innovative new technique. Eur Radiol. 2012 Dec;22(12):2822-35. Epub 2012 Aug 31.
Dick EA, Gedroyc WM. ExAblate magnetic resonance-guided focused ultrasound system in multiple body applications. Expert Rev Med Devices 2010 Sep;7(5):589-97.
Click here for additional references from PubMed.