Issn Print: 1098-7339

Publication Date: 2008/09/01


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Cooled Radiofrequency Denervation “Sinergy', as a Novel Treatment of Sacroiliac Joint Complex Pain Syndrome; A Pilot Study: 505

A. Avila; C. Restrepo; R. Alqasim; J. Anns; J. Lam-McCulloch; M. Avila; N. Carmichael

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Author Information: Sunnybrook HSC, Anesthesiology, Toronto, Canada

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Introduction: Sacroiliac joint pain syndrome is a complex and challenging pain condition exhibited by 15% to 25% of patients with chronic axial lower back pain.Prevalence studies are complicated by diagnostic methodology,non validated provocative tests, physical examination findings with interpersonal differences,pain history of subjective bias and insensitive image radiological testing. Although self evident the most common standard method to diagnose the sacroiliac joint as a pain generator is the intra-articular injection of local anesthetics with steroids, but it's validity remains unproven.Similarly highly successful long term treatments remains technically challenging and clinically unsettled.The Aim of this pilot study is:1)Asses the efficacy of SInergy in treating the sacroiliac joint pain by cooled radiofrequency denervation, 2) To stimulate further research into this challenging and complex disorder.
Material and Methods: 4 patients were selected for this prospective case series pilot study, with presumptive diagnosis of Sacroiliac joint complex pain syndrome, by history and physical examination, then underwent to 2 different arthrografically confirmed trials of local anesthetic/steroids sacroiliac joint injections.All had >80% reduction in pain scores (VAS).All 4 patients underwent COOLED RF (SINERGY),denervation of the Dorsal medial nerve branch of L4,dorsal nerve branch of L5, and lateral nerve branches of S1,S2 and S3.Assessments of pre and post denervation changes in (VAS) pain scores,pain diagrams,physical examination, opioide comsumption.BPI and quality of life scores.
Results: 3 patients experienced excellent(>75% reduction VAS) pain relief, 1 patient had good (>50%reduction VAS) pain relief, Also improved quality of life scores and opioides reduction.
Conclusion: This pilot study is the first step in suggest that COOLED Radiofrequency denervation “SINERGY” of the sacroiliac joint can significantly reduce pain, opioide and adjuvants comsumption and improve functional quality of life predictors in selected patients with sacroiliac joint complex pain syndromes.Sinergy appears to be an effective treatment for this challenging pain condition.Ramdomized control trials are needed to further evaluate its effectiveness.

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