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Ablation of Si Joint Under Spinal Endoscopy

  • Javier Quillo-Olvera
  • Jin-Sung Kim
Chapter

Abstract

The diagnosis of chronic low back pain secondary to dysfunction of the sacroiliac joint is a challenge for the spine surgeon and interventional pain specialist. The sacroiliac joint is an anatomical structure with an important function in the distribution of loads from the spine to the legs and vice versa. It also has a complex nerve network that gives it sensitivity and which is formed mainly by the lateral branches of the dorsal sacral ramus from S1 to S3 with the inconstant participation of L5 and S4. The treatment of the pain syndrome caused by this joint is equally complicated. Within the current options, there are intra-articular and periarticular injections, radiofrequency ablation, and, in selected cases, the fusion of the joint. This chapter presents the endoscopic-assisted radiofrequency ablation technique for sacroiliac joint pain. Also, the topographic anatomy, diagnosis of articular dysfunction, and current treatments are discussed for the correct understanding of the endoscopic technique.

Keywords

Chronic low back pain Sacroiliac joint Ablation Endoscopy Pain management Radiofrequency 

Abbreviations

AP

Anteroposterior

BMI

Body mass index

CT

Computerized tomography

FABER

Flexion abduction external rotation

K-ODI

Korean Oswestry disability index

LB

Lateral branch

LBB

Lateral branches block

LBP

Low back pain

MB

Medial branch

MRI

Magnetic resonance imaging

NRS

Numeric rating pain scale

NSAID

Nonsteroidal anti-inflammatory drugs

ODI

Oswestry disability index

PET

Positron emission tomography

PRF

Pulsed radiofrequency

PSIS

Posterior superior iliac spine

PSN

Posterior sacral network

RF

Radiofrequency

RSA

Radiostereometric analysis

SAP

Superior articular process

SIJ

Sacroiliac joint

SPECT

Single-photon emission computed tomography

STIR

Short-tau inversion recovery

T1CE

T1-weighted contrast-enhanced

T2FS

T2-weighted fat-saturated

VAS

Visual analogue scale

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Copyright information

© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  • Javier Quillo-Olvera
    • 1
  • Jin-Sung Kim
    • 1
  1. 1.Spine Center, Department of NeurosurgerySeoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaSeoulSouth Korea

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