riturupesh@gmail.com

To evaluate efficacy of MR guided Focused Ultraound Surgery( MRgFUS) in treatment of low backache due to facetal arthropathy by assessing symptomatic improvement in terms of decrease in Numerical rate score (NRS) and Oswestry Disability Index(ODI)

126 facet joints (L3-4 to L5-S1)in 21 patients in the age group 40 to 80 yrs were selected for study after approval from ethics committee.The inclusion criteria were LBP due to facetal arthropathy without significant Radiculopathy, Facet joint arthropathy without significant spinal canal or neural foraminal stenosis ,Diagnostic facet jt. injection with local anesthetic & steroid causing significant pain reduction (done in 10 patients ).All included patients had a NRS of >5 and ODI >50% Treatment was performed on GE 1.5 TESLA HDXT with EXBLATE 2000 in supine position under mild conscious sedation Immediate post treatment evaluation was done by identifying Post Contrast enhancement at the posterior margin of the facets joints.1 week, 1 month, 3 and 6 months follow up of all the patients was done by plotting of Numerical rate scale (NRS)scores, Oswestry Disability (ODI)scores .

Average pre treatment NRS was 9 ,which reduced to 4, 1 month following treatment and to 2 ,6 months following treatment The reduction in NRS score after 1 and 6 months is statistically significant (p=0.00001) Average pre treatment ODS 70% ,with reduction to 35% and 22% following 1 and 6 months respectively .By chi square test ,reduction in ODS was significant with p value of 0.0248 after 1 month and 0.0020 after 6 months .

MRgFUS is a safe and effective procedure in treatment of facetal arhropathy related pain in selected patients with no adverse effects or complications and can be performed on out patient basis .

MRgFUS is a non invasive modality providing good pain relief in facetal arthropathy ,with results comparable to other more invasive procedures like radiofrequency ablation