813: Comparison of Conventional Radiofrequency Lesioning (CRF) Treatment to the Pulsed Radiofrequency Lesioning (PRF) of Lateral Branches for Sacroiliac Joint Pain

2008 ◽  
Vol 33 (5) ◽  
pp. e100-e100
Author(s):  
N LULECI ◽  
A BAYSAL ◽  
U OZDEMIR ◽  
O SAVLUK
Keyword(s):  
Sacroiliac Joint ◽  
Joint Pain ◽  
Pulsed Radiofrequency ◽  
Sacroiliac Joint Pain ◽  
Lateral Branches

scholarly journals Comparison of Efficacy of Lateral Branch Pulsed Radiofrequency Denervation and Intraarticular Depot Methylprednisolone Injection for Sacroiliac Joint Pain

2018 ◽  
Vol 1 (21;1) ◽  
pp. 489-496
Author(s):  
Samarjit Dey
Keyword(s):  
Sacroiliac Joint ◽  
Joint Pain ◽  
Pulsed Radiofrequency ◽  
Sacroiliac Joint Pain ◽  
Post Procedure ◽  
Radiofrequency Denervation ◽  
Group A ◽  
Dorsal Rami ◽  
Group B ◽  
Lateral Branches

Background: Sacroiliac joint dysfunctional pain has always been an enigma to the pain physician, whether it be the diagnosis or the treatment. Diagnostic blocks are the gold standard way to diagnose this condition. Radiofrequency neurotomy of the nerves supplying the sacroiliac joint has shown equivocal results due to anatomical variation. Intraarticular depo-steroid injection is a traditional approach to treating sacroiliac joint pain. For long-term pain relief, however, lesioning the sacral lateral branches may be a better approach. Objective: This study compared the efficacy of intraarticular depo-methylprednisolone injection to that of pulsed radiofrequency ablation for sacroiliac joint pain. Study Design: This study used a randomized, prospective design. Setting: Thirty patients with diagnostic block-confirmed sacroiliac joint dysfunctional pain were randomly assigned to 2 groups. One group received intraarticular methylprednisolone and another group underwent pulsed radiofrequency of the L4 medial branch, the L5 dorsal rami, and the lateral sacral branches. Results: Reduction in Numeric Rating Scale (NRS) for pain at 1 month post-procedure remained similar in Group A, while in Group B few patients reported a further decrease in the NRS score (3.333 ± 0.4880 and 2.933 ± 0.5936, respectively). At 3 months post-procedure, the NRS score began to rise in most patients in group A, while in Group B, the NRS score remained the same since the last visit (4.400 ± 0.9856 and 3.067 ± 0.8837, respectively). At 6 months post-procedure, the NRS score began to rise further in most patients in group A. In Group B, the NRS score remained the same in most of the patients since the last visit (5.400 ± 1.549 and 3.200 ± 1.207). There was a marked difference between the 2 groups in Oswestry Disability Index (ODI) scores at 3 months post-procedure (Group A, 12.133 ± 4.486 vs Group B, 9.133 ± 3.523) and at 6 months post-procedure there was a significant (P = 0.0017) difference in ODI scores between Group A and Group B (13.067 ± 4.284 and 8.000 ± 3.703, respectively). Global Perceived Effect (GPE) was assessed in both groups at 3 months post-procedure Only 33.3% (Confidence Interval (CI) of 11.8- 61.6 ) of patients in Group A had positive GPE responses whereas in Group B, 86.67% (CI of 59.5- 98.3 ) of patients had positive GPE responses. At 6 months post-procedure, the proportion of patients with positive GPE declined further in Group A, while in Group B, positive GPE responses remained the same (20% with a CI of 4.30- 48.10 and 86.67% with a CI of 59.5- 98.3, respectively ). Limitations: Small sample size. Conclusion: This comparative study shows that pulsed radiofrequency denervation of the L4 and L5 primary dorsal rami and S1-3 lateral branches provide significant pain relief and functional improvement in patients with sacroiliac joint pain. Key words: Low back pain, sacroiliac joint dysfunctional pain, radiofrequency, intraarticular injection

Lateral branch blocks

2021 ◽  
pp. 75-82
Author(s):  
Benjamin K. Homra ◽  
Yashar Eshraghi ◽  
Maged Guirguis
Keyword(s):  
Radiofrequency Ablation ◽  
Local Anesthetic ◽  
Sacroiliac Joint ◽  
Joint Pain ◽  
Lateral Branch ◽  
Ultrasound Technique ◽  
Posterior Aspect ◽  
Sacroiliac Joint Pain ◽  
Lateral Branches

The posterior sacral network is a complex meshwork of lateral branches of the dorsal sacral rami that innervate the posterior aspect of the sacroiliac joint. Pain arising from this joint can be diagnostically targeted using either a fluoroscopic or ultrasound technique to determine if the patient would benefit from radiofrequency ablation of the lateral branches. Injecting local anesthetic near the dorsal foramina using these techniques will temporarily block the transmission of pain by the lateral branches from the sacroiliac joint. This chapter covers the anatomy of the posterior sacral network, discusses the details of the two techniques for lateral branch blocks and evidence for their utility, provides information about the risks and contraindications associated with the techniques, and concludes by discussing the implications of the procedure.

Dextrose injection of sacral lateral branches for chronic sacroiliac joint pain

2011 ◽  
Vol 12 (4) ◽  
pp. P69
Author(s):  
P. Satija ◽  
M. Parker ◽  
M. Eckmann ◽  
S. Ramamurthy
Keyword(s):  
Sacroiliac Joint ◽  
Joint Pain ◽  
Sacroiliac Joint Pain ◽  
Lateral Branches

Comparative Outcomes of Cooled Versus Traditional Radiofrequency Ablation of the Lateral Branches for Sacroiliac Joint Pain

2013 ◽  
Vol 29 (2) ◽  
pp. 132-137 ◽  
Author(s):  
Jianguo Cheng ◽  
Jason E. Pope ◽  
Jarrod E. Dalton ◽  
Olivia Cheng ◽  
Albatoul Bensitel
Keyword(s):  
Radiofrequency Ablation ◽  
Sacroiliac Joint ◽  
Joint Pain ◽  
Sacroiliac Joint Pain ◽  
Lateral Branches

scholarly journals A Systematic Evaluation of the Therapeutic Effectiveness of Sacroiliac Joint Interventions

2012 ◽  
Vol 3;15 (3;5) ◽  
pp. E247-E278 ◽  
Author(s):  
Hans Hansen
Keyword(s):  
Systematic Review ◽  
Sacroiliac Joint ◽  
Joint Pain ◽  
Randomized Trials ◽  
Low Back ◽  
Pulsed Radiofrequency ◽  
Short Term ◽  
Sacroiliac Joint Pain ◽  
Radiofrequency Neurotomy

Background: The contribution of the sacroiliac joint to low back and lower extremity pain has been a subject of debate with extensive research. It is generally accepted that approximately 10% to 25% of patients with persistent low back pain may have pain arising from the sacroiliac joints. In spite of this, there are currently no definite conservative, interventional, or surgical management options for managing sacroiliac joint pain. In addition, there continue to be significant variations in the application of various techniques as well as a paucity of literature. Study Design: A systematic review of therapeutic sacroiliac joint interventions. Objective: To evaluate the accuracy of therapeutic sacroiliac joint interventions. Methods: The available literature on therapeutic sacroiliac joint interventions in managing chronic low back and lower extremity pain was reviewed. The quality assessment and clinical relevance criteria utilized were the Cochrane Musculoskeletal Review Group criteria for randomized trials of interventional techniques and the criteria developed by the Newcastle-Ottawa Scale for observational studies. The level of evidence was classified as good, fair, or limited (or poor) based on the quality of evidence developed by the U.S. Preventive Services Task Force (USPSTF). Data sources included relevant literature published from 1966 through December 2011 that was identified through searches of PubMed and EMBASE, and manual searches of the bibliographies of known primary and review articles. Outcome Measures: The primary outcome measure was pain relief (short-term relief = up to 6 months and long-term > 6 months). Secondary outcome measures were improvement in functional status, psychological status, return to work, and reduction in opioid intake. Results: For this systematic review, 56 studies were considered for inclusion. Of these, 45 studies were excluded and a total of 11 studies met inclusion criteria for methodological quality assessment with 6 randomized trials and 5 non-randomized studies. The evidence for cooled radiofrequency neurotomy in managing sacroiliac joint pain is fair. The evidence for effectiveness of intraarticular steroid injections is limited (or poor). The evidence for periarticular injections of local anesthetic and steroid or botulinum toxin is limited (or poor). The evidence for effectiveness of conventional radiofrequency neurotomy is limited (or poor). The evidence for pulsed radiofrequency is limited (or poor). Limitations: The limitations of this systematic review include a paucity of literature on therapeutic interventions, variations in technique, and variable diagnostic standards for sacroiliac joint pain. Conclusions: The evidence was fair in favor of cooled radiofrequency neurotomy and limited (or poor) for short-term and long-term relief from intraarticular steroid injections, periarticular injections with steroids or botulin toxin, pulsed radiofrequency, and conventional radiofrequency neurotomy. Key words: Chronic low back pain, sacroiliac joint pain, sacroiliitis, sacroiliac joint injection, sacroiliac joint dysfunction, thermal radiofrequency, pulsed radiofrequency

Sign in / Sign up

Export Citation Format

Share Document