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Neurolyser XR
Started by interjectionreflection
Between their two human studies so far, their n is like 35 patients...and the trend of post-procedure pain levels over time in their data doesn't pass the face-validity test.
I do think HIFU holds promise for a number of applications, but for facet pain I have more questions than there seem to be answers.
I'll await (a lot) more data.
I do think HIFU holds promise for a number of applications, but for facet pain I have more questions than there seem to be answers.
I'll await (a lot) more data.
The way it shows up on my feed is sounding like it could replace a big chunk of what we do but I had no idea it was such a small number of patients
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Interventional pain docs do this in their studies. It still needs fluoro targeting and so docs with our skillset would still be needed to drive.
But there are so many unknowns to be answered about efficacy, durability, risks, etc.
And will current codes cover this? If new codes are needed, then add more years just for the companies to go to battle over that.
Another elephant in the room: time. Their average procedure time was 45 minutes…maybe they can significantly decrease it, or maybe not. But if not, then that would be tough to pencil over familiar alternatives unless codes are pretty beefy…
one thing is for sure. Medicare, insurance etc will not pay more for facet based interventions. Not happening so unless it’s cheaper and faster it will never catch on unless it lasts for much longer which is doubtful in which case self pay might come into play.
I saw a couple of academic centers have been introducing this lately and keep tauting HIFU. Anyone have any experience with these? Will this be something that is supposed to replace RFA over time?
I participated in FDA usability studies for MBB HIFU. It's cool, and it's effective.
I'm standing by. Other indications may be on the horizon. Think about areas of the body or skeleton where nerves sit very close to bone in an anatomically predictable way, and imagine being able to focus a HIFU beam through tissues to that target...#gamechanger
I'm standing by. Other indications may be on the horizon. Think about areas of the body or skeleton where nerves sit very close to bone in an anatomically predictable way, and imagine being able to focus a HIFU beam through tissues to that target...#gamechanger
I trained on it. I still don't understand how it'll work for billing as you don't break the skin at all, don't measure the temperature, and really are just lining it up on fluoro. It's cute and has some augmented reality stuff to help you make sure you hit the target. They said at the time it was only for lumbar MBBs, not for folks that are too thick, and if your field/angle of attack is off too much, you can get energy/heating on the nerve root.
I think the academic places are doing it to say they're doing it, because PP folks aren't excited to possibly lose money on the claw backs
Same codes as standard RFA because it produces a thermal lesion.
Yeah, I know they say that. I will see what CMS/payors/AMA says moving forward.
What temp at the nerve?
80+C?
Yes.
1) Does it last more than 6 months
2) Do you still need to do two sets of diagnostic medial branch blocks beforehand?
It sounds like the perfect cash pay device for chiropractors if there is no skin breakage to be honest. They can circumvent the MBBs when it’s cash.
2) Do you still need to do two sets of diagnostic medial branch blocks beforehand?
It sounds like the perfect cash pay device for chiropractors if there is no skin breakage to be honest. They can circumvent the MBBs when it’s cash.
Yeah, it is trying to do the usual MBB pathway but replace the RFA. They price their stuff as capital and the cost of the whole needle/grounding/sedation/etc. The only consumable was a gel coupler thing to the HIFU source and tap water
Yes.
Yes.
It creates a thermal lesion inside the body, so it's a form of surgery. Chiros can't do it. It's also being explored for brain tumors, so I think that the chiros might pick it up there.
High intensity focused ultrasound surgery (HIFU) of the brain: A historical perspective, with modern applications - PMC
The field of MRI-guided high intensity focused ultrasound surgery (MRgFUS) is a rapidly evolving one with many potential applications in neurosurgery. This is the first of three articles on MRgFUS, this paper focuses on the historical development of ...
pmc.ncbi.nlm.nih.gov
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