Cooled radiofrequency denervation for treatment of sacroiliac joint pain: two-year results from 20 cases

Kok-Yuen Ho, Mohamed Abdul Hadi, Koravee Pasutharnchat, Kian-Hian Tan, Kok-Yuen Ho, Mohamed Abdul Hadi, Koravee Pasutharnchat, Kian-Hian Tan

Abstract

Background: Sacroiliac joint pain is a common cause of chronic low back pain. Different techniques for radiofrequency denervation of the sacroiliac joint have been used to treat this condition. However, results have been inconsistent because the variable sensory supply to the sacroiliac joint is difficult to disrupt completely using conventional radiofrequency. Cooled radiofrequency is a novel technique that uses internally cooled radiofrequency probes to enlarge lesion size, thereby increasing the chance of completely denervating the sacroiliac joint. The objective of this study was to evaluate the efficacy of cooled radiofrequency denervation using the SInergy™ cooled radiofrequency system for sacroiliac joint pain.

Methods: The charts of 20 patients with chronic sacroiliac joint pain who had undergone denervation using the SInergy™ cooled radiofrequency system were reviewed at two years following the procedure. Outcome measures included the Numeric Rating Scale for pain intensity, Patient Global Impression of Change, and Global Perceived Effect for patient satisfaction.

Results: Fifteen of 20 patients showed a significant reduction in pain (a decrease of at least three points on the Numeric Rating Scale). Mean Numeric Rating Scale for pain decreased from 7.4 ± 1.4 to 3.1 ± 2.5, mean Patient Global Impression of Change was "improved" (1.4 ± 1.5), and Global Perceived Effect was reported to be positive in 16 patients at two years following the procedure.

Conclusion: Cooled radiofrequency denervation showed long-term efficacy for up to two years in the treatment of sacroiliac joint pain.

Keywords: ablation; chronic low back pain; intervention; neurotomy; sacroiliitis.

Figures

Figure 1
Figure 1
Lateral fluoroscopic view of the sacrum showing three separate 25-gauge spinal needles placed within the S1, S2, and S3 foramina.
Figure 2
Figure 2
Anteroposterior fluoroscopic view of the sacrum showing three separate 25-gauge spinal needles placed within the left S1, S2, and S3 foramina. An epsilon ruler is used as a guide such that the needle tip is positioned about 10 mm lateral to the posterior sacral foramina apertures. The radiofrequency electrode is positioned at the 11 o’clock position of the S1 foramen.

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Source: PubMed

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