Is the Technology Ready? Targeting, Reproducibility, and Safety Considerations That Paved the Way to the First Transcranial Focused Ultrasound Neuromodulation Clinical Trials

For fifteen years, focused ultrasound was a promise: reach any circuit in the nervous system with no incision, no lead, no implant. The promise just became a procedure. Twice. Thalamotomy for tremor and Parkinson's: a decade of outcomes, real coverage, patients waiting. And as of November 2025, medial branch neurotomy for low back pain: cleared, commercial, and sitting squarely in the interventional pain lane. Every technology has one moment when ownership is decided. Radiofrequency had it. Stimulation had it. This is ultrasound's moment, and it will belong to the specialists in the room when it turns: neurosurgeons and interventional pain physicians. One day at NANS. The pioneers who ran the pivotal trials. A routine case, start to finish. The reimbursement map. The machines, hands-on, at lunch. And the Build List: what this field still needs, and who will build it. The wave isn't coming. It's here. Own it.