MR Guided High Intensity Focused Ultrasound for Lumbar Back Pain

Inclusion criteria

• . Men and women \> 21 years of age and who are skeletally mature
• . Body mass index ≤ 30 kg/m2
• . Patients who are able to understand and willing to sign a written informed consent document and able to attend all study visits
• . Patients with at least 6 months of chronic lower back pain (LBP) localized to the midline or axial low back, with symptoms attributed to the facet joints on physical examination that have persisted despite conservative therapy. Conservative therapy is defined as systemic pain medications and anti-inflammatory medications, as well as physical therapy, such as massage, heating, hydrotherapy, and strengthening exercises.
• . Patients with Numerical Rating Scale worst lumbar back pain score of at least 4 out of 10 over the 24 hours preceding the time of rating.
• . Patients must have chronic LBP attributed to facet joints as demonstrated by MRI consistent with at least grade 2 facet joint arthritis, with corresponding abnormal activity at the facet joint on 18F-sodium fluoride PET-CT.
• . Patients must have an analgesic response to either prior local anesthetic injection to the facet joint or to radiofrequency ablation of the facet joint, with relapse of pain.
• . The targeted facet joint must be deeper than 10 mm from the skin

Exclusion criteria