Download PDF
J Neurol Surg A Cent Eur Neurosurg 2022; 83(02): 105-109
DOI: 10.1055/s-0041-1740439
Original Article

Preliminary Results of Endoscopic Radiofrequency Treatment of the Sacroiliac Joint Syndrome

Christian Woiciechowsky
1   Spine Center, Berlin, Germany
,
Leonie Mercedes Richter
1   Spine Center, Berlin, Germany
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

Background and Study The sacroiliac joint (SIJ) may be the primary source of pain in 15 to 25% of patients with axial low back pain. Furthermore, 75% of patients who have had fusion surgery develop SIJ pain within 10 years. Treatment options include SIJ blocks, radiofrequency (RF) denervation, and fusion. The RF techniques range from ablation of the nerves supplying the joint, creating lesions to the joint itself, or a combination of both techniques. However, different clinical studies could only identify a limited or, in some cases, no effect in decreasing of pain intensity and duration of the effect.

Methods In this retrospective study, we selected 23 patients with SIJ pain, with a duration of more than 12 months and a 50% pain reduction on the Numeric Rating Scale (NRS) after diagnostic block. All patients received endoscopic ablation of the medial branch L5/S1 and the lateral branches, exiting the sacral foramina on S1/S2 and S2/S3 on both sides while using only one incision on each side. Telephone interviews were conducted with all patients. The outcome was determined with Odom's criteria, percent reduction NRS, subjective assessment of the patient, and duration of the effect.

Results According to Odom's criteria, 79% of the patients showed acceptable to excellent results and confirmed that denervation helped them to manage their daily lives better. The average pain reduction in the responder group was 57% with an average duration of 13.4 months.

Conclusion In this retrospective study, we could demonstrate the practicability and effectiveness of endoscopic SIJ denervation in the treatment of SIJ pain using only one incision for three levels on each side. Further studies should investigate if this procedure is more effective than percutaneous RF.

Keywords

sacroiliac joint syndrome - radiofrequency - low back pain - spinal endoscopy


Publication History

Received: 20 October 2019

Accepted: 19 March 2020

Article published online:
17 November 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Tender G, Waguespack A, Crutcher C, Digiorgio A, Nader R. Sacro-iliac joint fusion. In: Tender G. ed. Minim Invasive Spine Surgery Technique. Cham: Springer; 2018: 147-154
    Google Scholar
  • 2 Tinnirello A, Barbieri S, Todeschini M, Marchesini M. Conventional (simplicity III) and cooled (SInergy) radiofrequency for sacroiliac joint denervation: one-year retrospective study comparing two devices. Pain Med 2017; 18 (09) 1731-1744
    CrossrefPubMedGoogle Scholar
  • 3 Cohen SP, Strassels SA, Kurihara C. et al. Outcome predictors for sacroiliac joint (lateral branch) radiofrequency denervation. Reg Anesth Pain Med 2009; 34 (03) 206-214
    CrossrefPubMedGoogle Scholar
  • 4 Hansen HC, McKenzie-Brown AM, Cohen SP, Swicegood JR, Colson JD, Manchikanti L. Sacroiliac joint interventions: a systematic review. Pain Physician 2007; 10 (01) 165-184
    CrossrefPubMedGoogle Scholar
  • 5 Rupert MP, Lee M, Manchikanti L, Datta S, Cohen SP. Evaluation of sacroiliac joint interventions: a systematic appraisal of the literature. Pain Physician 2009; 12 (02) 399-418
    CrossrefPubMedGoogle Scholar
  • 6 Bayerl SH, Finger T, Heiden P. et al. Radiofrequency denervation for treatment of sacroiliac joint pain-comparison of two different ablation techniques. Neurosurg Rev 2020; 43 (01) 101-107
    CrossrefPubMedGoogle Scholar
  • 7 Juch JNS, Maas ET, Ostelo RWJG. et al. Effect of radiofrequency denervation on pain intensity among patients with chronic lowback pain the mint randomized clinical trials. JAMA 2017; 318 (01) 68-81
    CrossrefPubMedGoogle Scholar
  • 8 Gupta A. Radiofrequency ablation techniques for chronic sacroiliac joint pain. Pain Med News. 2010; 8: 1-8
    PubMedGoogle Scholar
  • 9 Walter SG, Schildberg FA, Rommelspacher Y. Endoscopic sacrolumbar facet joint denervation in osteoarthritic and degenerated zygapophyseal joints. Arthrosc Tech 2018; 7 (12) e1275-e1279
    CrossrefPubMedGoogle Scholar
  • 10 Choi WS, Kim JS, Ryu KS, Hur JW, Seong JH, Cho HJ. Endoscopic radiofrequency ablation of the sacroiliac joint complex in the treatment of chronic low back pain: a preliminary study of feasibility and efficacy of a novel technique. BioMed Res Int 2016; 2016: 2834259
    PubMedGoogle Scholar
  • 11 Yoshihara H. Sacroiliac joint pain after lumbar/lumbosacral fusion: current knowledge. Eur Spine J 2012; 21 (09) 1788-1796
    CrossrefPubMedGoogle Scholar
  • 12 Rashbaum RF. Diagnosis and treatment of sacroiliac joint pain: sacrogenic pain. In: Whitaker C, Hochschuler S. eds. The Pocket Spine. 2nd ed.. Boca Raton, FL: CRC Press; 2014: 245-257
    Google Scholar
  • 13 Salman OH, Gad GS, Mohamed AA, Rafae HH, Abdelfatah AM. Randomized, controlled blind study comparing sacroiliac intra-articular steroid injection to radiofrequency denervation for sacroiliac joint pain. Egypt J Anaesth 2016; 32 (02) 219-225
    CrossrefPubMedGoogle Scholar
  • 14 Zaidi HA, Montoure AJ, Dickman CA. Surgical and clinical efficacy of sacroiliac joint fusion: a systematic review of the literature. J Neurosurg Spine 2015; 23 (01) 59-66
    CrossrefPubMedGoogle Scholar
  • 15 Maas ET, Ostelo RW, Niemisto L. et al. Radiofrequency denervation for chronic low back pain. Cochrane Database Syst Rev 2015; (10) CD008572
    PubMedGoogle Scholar