First Treatment of a Sacroiliitis Patient Using Fluoroscopy Guided High Intensity Focused Ultrasound for Sacroiliitis

Background: Sacroiliitis is a debilitating condition causing significant lower back pain. Current treatment options, including medication, physical therapy, and invasive procedures, have limitations. High-intensity focused ultrasound (HIFU) offers a noninvasive, image-guided approach to treat chronic pain. In this study, we aimed to evaluate the safety and efficacy of HIFU for the treatment of sacroiliitis in patients with sacroiliac joint (SIJ) pain. Methods: A single-arm, open-label, pilot study was conducted on eight patients with SIJ pain. HIFU treatments were performed using a fluoroscopy-guided system. Primary outcomes included pain intensity, functional disability, and quality of life. Results: The HIFU procedure was well-tolerated, with no significant adverse events reported. Patients demonstrated a statistically significant reduction in pain intensity (p < 0.005) along with a nonsignificant improvement in functional disability and quality of life over the 6-month follow-up period. Additionally, MRI imaging confirmed precise ablation of the targeted tissue. Conclusion: HIFU shows potential as a noninvasive treatment option for sacroiliitis. However, additional larger-scale studies are needed to further explore these findings and refine treatment parameters.