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

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summaryBackground and objectivesThe 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.MethodsForty-three patients with a long history of low back pain and confirmed SI-related 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 intra-articular injection with local anesthetics.ResultsWe 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.

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