TITLE:
Radiofrequency Neurotomy for Sacroiliac Joint Pain: A Prospective Study
AUTHORS:
Bruce Mitchell, Tomas MacPhail, David Vivian, Paul Verrills, Adele Barnard
KEYWORDS:
RFN, Radiofrequency Denervation, Radiofrequency Ablation, Sacroiliac Joint Pain, Patient Outcome Measures
JOURNAL NAME:
Surgical Science,
Vol.6 No.7,
July
3,
2015
ABSTRACT: Background: The sacroiliac joint (SIJ) is an important cause of chronic
low back pain, implicated in 15% - 30% of all cases. While radiofrequency
neurotomy (RFN) is the interventional treatment of choice for spinal pain
originating from the facet joints, fewer studies have investigated its potential
for treating SIJ pain, and its long-term efficacy is unknown. Objectives: To
obtain a real-world view of RFN treatment outcomes for SIJ pain by conducting
an observational study within a community pain practice, among a heterogeneous
patient group receiving standard-of-care diagnostic workup and treatment. Study
Design: A prospective, observational study, with data collection over five
years, was conducted at the authors' private practice. Patients & Methods: A cohort of 215 patients underwent
fluoroscopically guided SIJ RFN of the dorsal and lateral branches of S1-S3 and
the descending branch of L5. All patients had previously had their diagnosis of
SIJ pain confirmed by controlled comparative analgesic blocks of relevant
nerves, and recorded pre-procedure pain levels on the 11-point Numerical Rating
Scale (NRS). Outcome measures included pain, and a Likert scale
to measure alterations to analgesic use, changes to paid employment status and
patient satisfaction. Results: We demonstrate an average pain reduction of 2.3 ± 2.1 NRS points
following RFN (baseline pain score of 6.9 ± 1.7 to a follow-up average of 4.6 ±
2.7 NRS points; p ≤ 0.01). At a mean follow-up period of 14.9 ± 10.9
months (range 6 - 49 months), an overall 42.2% of patients reduced their
analgesic use. Of the patients for whom employment capacity was applicable (82
patients), 21 patients reported an improvement. Overall, 67% of patients were
satisfied with their outcome of post-RFN treatment. No complications occurred.
Limitations: This observational study had no independent control group and only
included a single study site. Conclusions: RFN is a safe and effective
treatment for pain confirmed to originate from the sacroiliac joint.