Lateral branch blocks as a treatment for sacroiliac joint pain: A pilot study.
OBJECTIVE
Pain arising from the sacroiliac (SI) joint is a common cause of low back pain for which there is no universally accepted, long-term treatment. Previous studies have shown radiofrequency (RF) procedures to be an effective treatment for other types of spinal pain. The purpose of this study was to determine the efficacy of reducing SI joint pain by percutaneous RF lesioning of the nerves innervating the SI joint.


METHODS
Eighteen patients with confirmed SI joint pain underwent nerve blocks of the L4-5 primary dorsal rami and S1-3 lateral branches innervating the affected joint. Those who obtained 50% or greater pain relief from these blocks proceeded to undergo RF denervation of the nerves.


RESULTS
Thirteen of 18 patients who underwent L4-5 dorsal rami and S1-3 lateral branch blocks (LBB) obtained significant pain relief, with 2 patients reporting prolonged benefit. At their next visit, 9 patients who experienced >50% pain relief underwent RF lesioning of the nerves. Eight of 9 patients (89%) obtained >/=50% pain relief from this procedure that persisted at their 9-month follow-up.


CONCLUSIONS
In patients with SI joint pain who respond to L4-5 dorsal rami and S1-3 LBB, RF denervation of these nerves appears to be an effective treatment. Randomized, controlled trials are needed to further evaluate this procedure.
Cohen
Steven P
SP
Pain Management Center, Departments of Anesthesiology, Walter Reed Army Medical Center, Washington, D.C., USA. Steven.Cohen@med.nyu.edu
Abdi
Salahadin
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003714:Denervation; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D010865:Pilot Projects; D011859:Radiography; D012189:Retrospective Studies; D012446:Sacroiliac Joint / Q000000981:diagnostic imaging; D016896:Treatment Outcome