Radiofrequency neuroablation in the treatment of pain syndrome of the sacroiliac joint
Background. Dysfunction of the sacroiliac joint (SJ) plays an important role in the formation of pain syndrome of lumbosacral localization. Radiofrequency neuroablation of SJ can be an alternative treatment in pain syndrome if intraarticular injections of hormonal drugs are ineffective. Multiple studies confirm data about the significant effectiveness of radiofrequency ablation of nerves innervating SJ for a period of 6–12 months. Purpose of the research: to analyze the effectiveness of radiofrequency neuroablation of SJ. Materials and methods. We conducted a prospective study of data in 48 patients (12 men and 36 women) aged 53 to 90 years, who were treated in the outpatient department of State Institution “Institute of Traumatology and Orthopaedics of the NAMS of Ukraine”. Results. A decrease in pain syndrome according to the Visual Analogue Scale (regression of pain by 3–10 points) was established 12 months after in 83 % of patients. Significant improvement was observed in 77 % of persons according to the results of quality of life assessment (Roland-Morris questionnaire) in 12 months. Analysis of treatment outcomes (by the index of recovery) 12 months after revealed: excellent results in 38 %, good — in 42 % of patients, satisfactory — in 20 % (among them — deterioration compared with baseline was noted in 8.3 % of cases). Conclusions. Radiofrequency neuroablation is an effective method for treating pain in the sacroiliac joint. The effect of the procedure is long-term (more than 12 months), and when relapse of the pain syndrome occurs, it is possible to repeat procedures.
Full Text:PDF (Русский)
Chernenko OA. Treatment of pain musculoskeletal lumbar syndromes. RMJ. 2000;(10):408-10. (in Russian).
Liliang PC, Lu K, Weng HC, Liang CL, Tsai YD, Chen HJ. The therapeutic efficacy of sacroiliac joint blocks with triamcinol one acetonide in the treatment of sacroiliac joint dysfunction without spondyloarthropathy. Spine (Phila Pa 1976). 2009 Apr 20;34(9):896-900. doi: 10.1097/BRS.0b013e31819e2c78.
Cohen SP, Strassels SA, Kurihara C, et al. Outcome predictors for sacroiliac joint (lateral branch) radiofrequency denervation. Reg Anesth Pain Med. 2009 May-Jun;34(3):206-14. doi: 10.1097/AAP.0b013e3181958f4b.
Hirabayashi К, Miyakawa J, Satomi K. Operative results and postoperative progression of ossification among patients with ossification of cervical posterior longitudinal ligament. Spine (Phila Pa 1976). 1981 Jul-Aug;6(4):354-64. doi: 10.1097/00007632-198107000-00005.
Benzon H, Rathmell J, Wu C, Turk D, Argoff C, Hurley R. Practical Management of Pain, 5th ed. Mosby; 2014. 1144 p.
Gevargez A, Groenemeyer D, Schirp S, Braun M. CT-guided percutaneous radiofrequency denervation of the sacroiliac joint. Eur Radiol. 2002 Jun;12(6):1360-5. doi: 10.1007/s00330-001-1257-2.
Yin W, WillarCohen SP, Abdi S. Lateral branch blocks as a treatment for sacroiliac joint pain: a pilot study. Reg Anesth Pain Med. 2003 Mar-Apr;28(2):113-9. doi: 10.1053/rapm.2003.50029.
d F, Carreiro J, Dreyfuss P. Sensory stimulation guided sacroiliac join radiofrequency neurotomy: technique based on neuroanatomy of the dorsal sacral plexus. Spine (Phila Pa 1976). 2003 Oct 15;28(20):2419-25. doi: 10.1097/01.BRS.0000085360.03758.C3.
Karaman H, Kavak GO, Tufek A. Cooled radiofrequency application for treatment of sacroiliac joint pain. Acta Neurochir (Wien). 2011 Jul;153(7):1461-8. doi: 10.1007/s00701-011-1003-8.
Patel N, Gross A, Brown L, Gekht G. A randomized, placebo-controlled study to assess the efficacy of lateral branch neurotomy for chronic sacroiliac joint pain. Pain Med. 2012 Mar;13(3):383-98. doi: 10.1111/j.1526-4637.2012.01328.x.
Cohen SP, Hurley RW, Buckenmaier CC 3rd, Kurihara C, Morlando B, Dragovich A. Randomized placebo-controlled study evaluating lateral branch radiofrequency denervation for sacroiliac joint pain. Anesthesiology. 2008 Aug;109(2):279-88. doi: 10.1097/ALN.0b013e31817f4c7c .
Maas ET, OsteloRW, Niemisto L, et al. Radiofrequency denervation for chronic low back pain. Cochrane Database Syst Rev. 2015 Oct 23;(10):CD008572. doi: 10.1002/14651858.CD008572.pub2.
Copyright (c) 2020 Ya.V. Fishchenko, A.P. Kudrin, L.D. Kravchuk
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2020