Cooled radiofrequency application for treatment of sacroiliac joint pain

• Published in: Acta neurochirurgica 2011-07, Vol.153 (7), p.1461-1468
• Main Authors: Karaman, Haktan, Kavak, Gönül Ölmez, Tüfek, Adnan, Çelik, Feyzi, Yıldırım, Zeynep Baysal, Akdemir, Mehmet Salim, Tokgöz, Orhan
• Format: Article
• Language: English
• Subjects: Adult; Aged; Arthralgia - pathology; Arthralgia - surgery; Catheter Ablation - instrumentation; Catheter Ablation - methods; Clinical Article; Denervation - instrumentation; Denervation - methods; Female; Humans; Interventional Radiology; Low Back Pain - pathology; Low Back Pain - surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Minimally Invasive Surgery; Neurology; Neuroradiology; Neurosurgery; Pain Measurement - methods; Sacroiliac Joint - innervation; Sacroiliac Joint - pathology; Sacroiliac Joint - surgery; Spinal Nerves - surgery; Surgical Orthopedics
• ISSN: 0001-6268; 0942-0940
• DOI: 10.1007/s00701-011-1003-8

Background The unavailability of an effective and long-lasting treatment for sacroiliac-based pain has led researchers to study the efficacy of radiofrequency in denervation. In this study, we aimed to investigate the efficacy and safety of novel cooled radiofrequency application for sacral lateral-branch denervation. Methods Patients experiencing chronic sacroiliac pain were selected for our observational study. Fluoroscopy guidance cooled radiofrequency denervation was applied on the L5 dorsal ramus and the S1-3 lateral branches on patients who had twice undergone consecutive joint blockages to confirm the diagnosis and obtained at least 75% pain relief. At the 1st, 3rd and 6th month postoperatively, the patients’ pain was evaluated using a visual analog scale (VAS), and their physical function was evaluated with the Oswestry Disability Index (ODI). Results Cooled radiofrequency was applied on a total of 15 patients. Prior to the procedures, the median VAS score (interquartile range) was 8 (7–9), but at the 1st, 3rd and 6th month, this had fallen to 3 (1–4), 2 (1–3) and 3 (2–4). The baseline median ODI score (interquartile range) was 36 (32–38), while at the 1st, 3rd and 6th month, it was 16 (8–20), 12 (9–18) and 14 (10–20), respectively. At the final control, while 80% of the patients reported at least a 50% decline in pain scores, 86.7% of those reported at least a ten-point reduction in ODI scores. Conclusion It was seen that the cooled radiofrequency used for sacroiliac denervation was an effective and safe method in the short to intermediate term.