慢性腰痛 (LBP) 是世界范围内导致残疾的主要原因，传统药物疗法无法为许多患有这种疾病的人提供缓解。据估计，15% 的慢性 LBP 病例可归因于小关节。高强度聚焦超声 (HIFU) 是一项最新技术，可以对组织进行无创热消融，并已显示出治疗肿瘤、神经性疼痛和骨转移疼痛的功效。在这篇系统综述中，作者总结了 HIFU 治疗腰椎小关节介导的疼痛的文献，并报告了 HIFU 对疼痛结果的有效性。筛选了所有描述使用聚焦超声治疗小关节疼痛的全文英文文章使用 PubMed/MEDLINE、Embase、Cochrane Library、Scopus 和 Web of Science 数据库。使用非随机研究的方法学指数评估临床研究的偏倚。纳入了 11 项研究（6 项临床前和 5 项临床）报告，涉及 50 名患者。其中 8 项研究 (73%) 使用 MR 引导的聚焦超声消融，3 项使用透视检查。内侧支神经和后小关节囊是聚焦消融最常见的目标。尽管使用的能量范围为 300 至 2000 焦耳，但临床研究主要在 1000 至 1500 焦耳范围内进行。所有临床研究中均观察到疼痛减轻，6-12 个月内平均基线疼痛评分多点减少。没有研究报告任何不良事件或并发症。HIFU 可有效治疗小关节引起的慢性腰痛。进一步的临床研究应探讨 HIFU 的长期效果并监测疼痛减轻随时间的变化。

Chronic low-back pain (LBP) is a leading cause of disability worldwide, and traditional pharmacotherapy fails to provide relief for many individuals with this condition. An estimated 15% of chronic LBP cases can be attributed to the facet joint. High-intensity focused ultrasound (HIFU) is a recent technology that enables noninvasive thermal ablation of tissue and has shown efficacy in treating tumors, neuropathic pain, and painful bone metastases. In this systematic review, the authors summarize the literature on lumbar facet joint-mediated pain treated with HIFU and report the effectiveness of HIFU on pain outcomes.All full-text English-language articles describing the use of focused ultrasound for facet joint pain were screened using the PubMed/MEDLINE, Embase, Cochrane Library, Scopus, and Web of Science databases. Clinical studies were assessed for bias using the methodological index for nonrandomized studies.Eleven studies (6 preclinical and 5 clinical) reporting on 50 patients were included. Eight of these studies (73%) used MR-guided focused ultrasound ablation and 3 used fluoroscopy. The medial branch nerve and posterior facet joint capsule were the most common targets for focused ablation. Although the energy used ranged from 300 to 2000 J, clinical studies predominantly operated in the range of 1000 to 1500 J. Pain reduction was seen in all clinical studies, with multiple-point reductions from average baseline pain scores in 6-12 months. No study reported any adverse events or complications.HIFU can be effective in treating chronic low-back pain arising from the facet joint. Further clinical studies should explore the long-term effects of HIFU and monitor changes in pain reduction over time.