Radiofrequency treatment of sacroiliac joint-related pain aimed at the first three sacral dorsal rami: a minimal approach

Abstract

Abstract Background and objectives: The sacroiliac joint (SIJ) is a potential source of low back pain. Establishing the diagnosis of SIJ syndrome is difficult because there are no specific criteria to confirm this syndrome. SIJ-related pain can be treated by multiple intra-articular injections (with a local anesthetic combined with a long acting steroid) or with a radiofrequency (RF) denervation technique. Three RF techniques have already been described. In this paper the authors describe a new RF approach in denervating the SIJ under fluoroscopic guidance, with only 3 punctures, based on its innervation. Methods: Forty-three patients with a long history of low back pain and confirmed SIrelated SIJ pain were selected on basis of presence of tenderness over the SIJ region on palpation, elucidation of pain by provocation tests, and a temporary pain relief after intraarticular injection with local anesthetics. Results: We performed 49 procedures in 43 patients. After 12 weeks, 15 of the 49 RF SI procedures (34.9%) resulted in complete pain relief, while another 14 (32.6%) reported pain relief of 50% or more. This was respectively in 10 (26.3%) and 13 (34.2%) of the patients. One patient who was treated on both sides has complete relief on one side, and >50% pain relief at the other side. So, in total 63.2% claimed a 50% decrease of pain or more. One patient complained of increased pain. There were no other complications. Relatively more female patients reported pain relief after the treatment.Keywords: RADIOFREQUENCYSACROILIAC JOINTLOW BACK PAIN.