Radiofrequency Denervation for Management of Chronic Sacroiliac Joint Pain

Abstract

Background Data: The largest axial joint in the body is the sacroiliac (SI) joint. Understanding the innervation of the SI joint is essential when contemplating denervation procedures. Current evidence favors lateral branch radiofrequency (RF) lesioning as the most effective treatment option. Moreover, it is an alternative treatment for refractory cases of SI joint pain. Purpose: To evaluate the efficacy and safety of percutaneous RF lateral neurotomy of sacroiliac joint in chronic back pain states. Study Design: Clinical prospective study. Patients and Methods: This study was conducted on 30 patients in Ain Shams University hospitals, Department of Neurosurgery, and Ain Shams Specialized Hospital in the period from 2014 to 2016. Patients included 18 females and 12 males in the study diagnosed clinically and radiologically with sacroiliac joint chronic pain. All patients underwent radiofrequency denervation for L5 dorsal branch, S1, S2, and S3 lateral branches of the dorsal primary rami lateral to the dorsal sacral foramina under fluoroscopy using local anesthesia and conscious sedation technique. Results: All patients were followed up at 1-, 3-, 6-, and 12-month intervals regarding pain relief, Visual Analogue Scale (VAS), and Patient Satisfaction Index (PSI) and results were analyzed. There was a significant decrease in pain score after radiofrequency denervation at 1 and 3 months (more than half of VAS after procedure) with high statistical significance. Conclusion: Radiofrequency sacroiliac denervation is a safe and effective procedure in management of chronic sacroiliac joint (SIJ) pain syndrome. The effect regarding pain relief seems to be fading with prolonged time interval after the procedure. Longer duration of follow-up and comparison with other placebo group are recommended for future studies (2019ESJ179).

Keywords

• Sacroiliac joint
• chronic back pain
• radiofrequency
• denervation.