Key Points
- Researchers at The Israel Institute of Technology investigated whether focused ultrasound could be used to alleviate chronic pain occurring after limb amputation.
- Physicians applied focused ultrasound to six stump neuromas in five participants.
- The team struggled to reach ablative temperatures, but the treatment temporarily decreased pain intensity for up to three months.
Feasibility of Magnetic Resonance-Guided High-Intensity-Focused Ultrasound (MRgHIFU) Ablation of Stump Neuromas for the Relief of Chronic Postamputation Neuropathic Pain
The results from a Foundation-funded clinical trial conducted in Israel have recently been published. Researchers at The Technion, Israel Institute of Technology, in Haifa, sought to determine whether focused ultrasound could be used to alleviate chronic pain that occurs after limb amputation, because a high percentage (70%) of amputees experience phantom pain and neuropathic pain after limb loss. These patients often develop neuromas in the affected limb. A neuroma is a benign growth of nerve tissue that is often called a “nerve tumor.” It causes burning, tingling, shooting pain, or numbness.
Instead of the current invasive surgeries to ablate neuromas, physicians used the Insightec Exablate body system to apply magnetic resonance–guided high-intensity focused ultrasound (MRgHIFU) to six stump neuromas in five participants.
In this feasibility study, the team was only able to reach an ablative temperature (> 65°C) at the neuroma in one participant, but the treatments did temporarily decrease the intensity of the pain (from 5.7 to 4.3, which increased back to 5.6 at 3- and 6-months of follow-up). One participant experienced bone necrosis. The team determined that further studies are warranted for this application and suggested the creation of a modified device with a dome-shaped transducer that can be placed around the amputated limb. Solving these technical challenges may allow for a more effective treatment.
See Journal of Ultrasound in Medicine >
Related Stories
Diseases and Conditions: Painful Amputation Neuromas and Neuropathic Pain
Focus Feature: Focused Ultrasound and Chronic Pain July 2019
Stump Neuroma Trial Begins August 2017