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Radiofrequency Ablation for Sacroiliac Joint Pain

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Radiofrequency Treatments on the Spine

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Abstract

The sacroiliac joint (SIJ) is the largest axial joint in the human body. It is a unique joint, with significantly decreased and unconventional motion compared to other synovial joints. Along with its curved shape, these characteristics make it a difficult joint to study. It is an important source of chronic low back pain, which is the leading cause of disability in the United States [1–3]. An estimated 15–25 % of low back pain patients may have SIJ pain as the cause of their symptoms. Furthermore, according to several sources, this figure may be an underestimate [4–10]. The anatomy and physiology of SIJs are unique, which makes accurate diagnosis and management very challenging.

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References

  1. US Burden of Disease Collaborators (2013) The state of US health, 1999–2010: Burden of diseases, injuries, and risk factors. JAMA 310:591–608

    Article  Google Scholar 

  2. Martin BI, Turner JA, Mirza SK, Lee MJ, Comstock BA, Deyo RA (2009) Trends in health care expenditures, utilization, and health status among US adults with spine problems, 1997–2006. Spine (Phila Pa 1976) 34:2077–2084

    Article  Google Scholar 

  3. Gaskin DJ, Richard P (2012) The economic costs of pain in the United States. J Pain 13:715–724

    Article  PubMed  Google Scholar 

  4. Cohen SP, Chen Y, Neufeld NJ (2013) Sacroiliac joint pain: a comprehensive review of epidemiology, diagnosis and treatment. Expert Rev Neurother 13:99–116

    Article  CAS  PubMed  Google Scholar 

  5. Forst SL, Wheeler MT, Fortin JD, Vilensky JA (2006) The sacroiliac joint: anatomy, physiology, and clinical significance. Pain Physician 9:61–67

    PubMed  Google Scholar 

  6. Manchikanti L, Abdi S, Atluri S, Benyamin RM, Boswell MV, Buenaventura RM, Bryce DA, Burks PA, Caraway DL, Calodney AK, Cash KA, Christo PJ, Cohen SP, Colson J, Conn A, Cordner HJ, Coubarous S, Datta S, Deer TR, Diwan SA, Falco FJE, Fellows B, Geffert SC, Grider JS, Gupta S, Hameed H, Hameed M, Hansen H, Helm S II, Janata JW, Justiz R, Kaye AD, Lee M, Manchikanti KN, McManus CD, Onyewu O, Parr AT, Patel VB, Racz GB, Sehgal N, Sharma M, Simopoulos TT, Singh V, Smith HS, Snook LT, Swicegood J, Vallejo R, Ward SP, Wargo BW, Zhu J, Hirsch JA (2013) An update of comprehensive evidence-based guidelines for interventional techniques of chronic spinal pain: part II: guidance and recommendations. Pain Physician 16:S49–S283

    PubMed  Google Scholar 

  7. Simopoulos TT, Manchikanti L, Singh V, Gupta S, Hameed H, Diwan S, Cohen SP (2012) A systematic evaluation of prevalence and diagnostic accuracy of sacroiliac joint interventions. Pain Physician 15:E305–E344

    PubMed  Google Scholar 

  8. Hansen H, Manchikanti L, Simopoulous TT, Christo PJ, Gupta S, Smith HS, Hameed H, Cohen SP (2012) A systematic evaluation of the therapeutic effectiveness of sacroiliac joint interventions. Pain Physician 15:E247–E278

    PubMed  Google Scholar 

  9. Cher D, Polly D, Berven S (2014) Sacroiliac joint pain: burden of disease. Med Devices (Auckl) 7:73–81

    Article  Google Scholar 

  10. Cox RC, Fortin JD (2014) The anatomy of the lateral branches of the sacral dorsal rami: implications for radiofrequency ablation. Pain Physician 17:459–464

    PubMed  Google Scholar 

  11. Vleeming A, Schuenke MD, Masi AT, Carreiro JE, Danneels L, Willard FH (2012) The sacroiliac joint: an overview of its anatomy, function and potential clinical implications. J Anat 221(6):537–567

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Roberts SL, Burnham RS, Ravichandiran K, Agur AM, Loh EY (2014) Cadaveric study of sacroiliac joint innervation: implications for diagnostic blocks and radiofrequency ablation. Reg Anesth Pain Med 39(6):456–464

    Article  PubMed  Google Scholar 

  13. Greenman PE (1990) Clinical aspects of sacroiliac function in walking. J Manual Med 5:25–30

    Google Scholar 

  14. Paterno J, Rathmell J, Gilligan C. Chapter 88 Cryoanalgesia and Radiofrequency Ablation. McGraw-Hill Education, New York, NY. 2015. In Press

    Google Scholar 

  15. Chou LH, Slipman CW, Bhagia SM et al (2004) Inciting events initiating injection-proven sacroiliac joint syndrome. Pain Med 5:26–32

    Article  PubMed  Google Scholar 

  16. Hooten WM, Cohen SP (2015) Evaluation and treatment of low back pain: a clinically focused review for primary care specialists. Mayo Clin Proc 90(12):1699–1718, Review

    Article  PubMed  Google Scholar 

  17. Szadek KM, van der Wurff P, van Tulder MW, Zuurmond WW, Perez RR (2008) Diagnostic validity of criteria for sacroiliac joint pain: a systematic review. J Pain 10:354–368

    Article  PubMed  Google Scholar 

  18. Song IH, Carrasco-Fernández J, Rudwaleit M, Sieper J (2008) The diagnostic value of scintigraphy in assessing sacroiliitis in ankylosing spondylitis: a systematic literature research. Ann Rheum Dis 67:1535–1540

    Article  CAS  PubMed  Google Scholar 

  19. Rubinstein SM, van Tulder M (2008) A best-evidence review of diagnostic procedures for neck and low-back pain. Best Pract Res Clin Rheumatol 22:471–482

    Article  PubMed  Google Scholar 

  20. Simopoulos TT, Manchikanti L, Gupta S, Aydin SM, Kim CH, Solanki D, Nampiaparampil DE, Singh V, Staats PS, Hirsch JA (2015) Systematic review of the diagnostic accuracy and therapeutic effectiveness of sacroiliac joint interventions. Pain Physician 18(5):E713–E756, Review

    PubMed  Google Scholar 

  21. Muhlner SB (2009) Review article: radiofrequency neurotomy for the treatment of sacroiliac joint syndrome. Curr Rev Musculoskelet Med 2(1):10–14

    Article  PubMed  PubMed Central  Google Scholar 

  22. Buijs EJ, van Wijk RM, Geurts JW, Weeseman RR, Stolker RJ, Groen GG (2004) Radiofrequency lumbar facet denervation: a comparative study of the reproducibility of lesion size after 2 current radiofrequency techniques. Reg Anesth Pain Med 29(5):400–407

    PubMed  Google Scholar 

  23. Gevargez A, Groenemeyer D, Schirp S, Braun M (2002) CT guided percutaneous radiofrequency denervation of the sacroiliac joint. Eur Radiol 12:1360–1365

    Article  CAS  PubMed  Google Scholar 

  24. Cohen SP, Salahadin A (2003) Lateral branch blocks as a treatment for sacroiliac joint pain: a pilot study. Reg Anesth Pain Med 28:113–119

    PubMed  Google Scholar 

  25. Buijs E, Kamphuis E, Groen G (2004) Radiofrequency treatment of sacroiliac joint-related pain aimed at the first three sacral dorsal rami: a minimal approach. Pain Clin 16:139–146

    Article  Google Scholar 

  26. Ferrante FM, King LF, Roche EA, Kim PS, Aranda M, Delaney LR, Mardini IA, Mannes AJ (2001) Radiofrequency sacroiliac joint the denervation for sacroiliac syndrome. Reg Anesth Pain Med 26:137–142

    Article  CAS  PubMed  Google Scholar 

  27. Yin W, Willard F, Carreiro J, Dreyfuss P (2003) Sensory stimulation-guided sacroiliac joint radiofrequency neurotomy: technique based on neuroanatomy of the dorsal sacral plexus. Spine (Phila Pa 1976) 28(20):2419–2425

    Article  Google Scholar 

  28. Fortin JD, Kissling RO, O’Connor BL, Vilensky JA (1999) Sacroiliac joint innervation and pain. Am J Orthop 28:687–690

    CAS  PubMed  Google Scholar 

  29. Ikeda R (1991) Innervation of the sacroiliac joint. Macroscopic and histological studies. Nippon Ika Daigaku Zasshi 58:587–596

    Article  CAS  PubMed  Google Scholar 

  30. Grob KR, Neuhuber WL, Kissling RO (1995) Innervation of the sacroiliac joint of the human. Z Rheumatol 54:117–122

    CAS  PubMed  Google Scholar 

  31. Ebraheim NA, Lu J, Biyani A, Huntoon M, Yeasting RA (1997) The relationship of lumbosacral plexus to the sacrum and the sacroiliac joint. Am J Orthop 26:105–110

    CAS  PubMed  Google Scholar 

  32. Cohen SP, Strassels SA, Kurihara C, Crooks MT, Erdek MA, Forsythe A, Marcuson M (2009) Outcome predictors for sacroiliac joint (lateral branch) radiofrequency denervation. Reg Anesth Pain Med 34(3):206–214

    Article  PubMed  Google Scholar 

  33. Perez RS, Zuurmond WW, Bezemer PD et al (2003) The treatment of complex regional pain syndrome type I with free radical scavengers: a randomized controlled study. Pain 102:297–307

    Article  CAS  PubMed  Google Scholar 

  34. Tanaka N, Sakahashi H, Sato E et al (2002) Intra-articular injection of high molecular weight hyaluronan after arthrocentesis as treatment for rheumatoid knees with joint effusion. Rheumatol Int 22:151–154

    Article  CAS  PubMed  Google Scholar 

  35. Quigley MR, Bost J, Maroon JC et al (1998) Outcome after microdiscectomy: results of a prospective single institutional study. Surg Neurol 49:263–267

    Article  CAS  PubMed  Google Scholar 

  36. Ballantyne JC, Mao J (2003) Opioid therapy for chronic pain. N Engl J Med 349:1943–1953

    Article  CAS  PubMed  Google Scholar 

  37. Fishbain DA, Cole B, Lewis J et al (2008) What percentage of chronic nonmalignant pain patients exposed to chronic opioid analgesic therapy develop abuse/addiction and/or aberrant drug-related behaviors? A structured evidence-based review. Pain Med 9:444–459

    Article  PubMed  Google Scholar 

  38. Cohen SP, Christo PJ, Wang S et al (2008) The effect of opioid dose and treatment duration on the perception of a painful standardized clinical stimulus. Reg Anesth Pain Med 33:199–206

    Article  CAS  PubMed  Google Scholar 

  39. Wasan AD, Butler SF, Budman SH et al (2007) Psychiatric history and psychologic adjustment as risk factors for aberrant drug-related behavior among patients with chronic pain. Clin J Pain 23:307–315

    Article  PubMed  Google Scholar 

  40. Mitchell B, Macphail T, Vivian D, Verrills P, Barnard A (2015) Radiofrequency neurotomy for sacroiliac joint pain: a prospective study. Surg Sci 06(07):265–272

    Article  Google Scholar 

  41. van Kleef M, Barendse GA, Kessels A et al (1999) Randomized trial of radiofrequency lumbar facet denervation for chronic low back pain. Spine 24:1937–1942

    Article  PubMed  Google Scholar 

  42. Vallejo R, Benyamin RM, Kramer J, Stanton G, Joseph NJ (2006) Pulsed radiofrequency denervation for the treatment of sacroiliac joint syndrome. Pain Med 7(5):429–434

    Article  PubMed  Google Scholar 

  43. Rupert MP, Lee M, Manchikanti L, Datta S, Cohen SP (2009) Evaluation of sacroiliac joint interventions: a systematic appraisal of the literature. Pain Physician 12(2):399–418

    PubMed  Google Scholar 

  44. Cohen SP, Hurley RW, Buckenmaier CC 3rd, Kurihara C, Morlando B, Dragovich A (2008) Randomized placebo-controlled study evaluating lateral branch radiofrequency denervation for sacroiliac joint pain. Anesthesiology 109(2):279–288

    Article  PubMed  PubMed Central  Google Scholar 

  45. Patel N, Gross A, Brown L, Gekht G (2012) A randomized, placebo-controlled study to assess the efficacy of lateral branch neurotomy for chronic sacroiliac joint pain. Pain Med 13:383–398

    Article  PubMed  Google Scholar 

  46. Stelzer W, Aiglesberger M, Stelzer D, Stelzer V (2013) Use of cooled radiofrequency lateral branch neurotomy for the treatment of sacroiliac joint-mediated low back pain: a large case series. Pain Med 14:29–35

    Article  PubMed  Google Scholar 

  47. Cheng J, Pope JE, Dalton JE, Cheng O, Bensitel A (2013) Comparative outcomes of cooled versus traditional radiofrequency ablation of the lateral branches for sacroiliac joint pain. Clin J Pain 29:132–137

    Article  PubMed  Google Scholar 

  48. Patel N, Cohen SP (2013) Response to: Cheng et al. Comparative outcomes of cooled versus traditional radiofrequency ablation of the lateral branches for sacroiliac joint pain. Clin J Pain 2013;29:132–137. Clin J Pain 29(12):1097–1098

    Article  PubMed  Google Scholar 

  49. Pino CA, Hoeft MA, Hofsess C, Rathmell JP (2005) Morphologic analysis of bipolar radiofrequency lesions: implications for treatment of the sacroiliac joint. Reg Anesth Pain Med 30(4):335–338

    PubMed  Google Scholar 

  50. Cosman ER Jr, Gonzalez CD (2011) Bipolar radiofrequency lesion geometry: implications for palisade treatment of sacroiliac joint pain. Pain Pract 11(1):3–22

    Article  PubMed  Google Scholar 

  51. Burnham RS, Yasui Y (2007) An alternate method of radiofrequency neurotomy of the sacroiliac joint: a pilot study of the effect on pain, function, and satisfaction. Reg Anesth Pain Med 32(1):12–19

    PubMed  Google Scholar 

  52. Schmidt PC, Pino CA, Vorenkamp KE (2014) Sacroiliac joint radiofrequency ablation with a multilesion probe: a case series of 60 patients. Anesth Analg 119:460–462

    Article  PubMed  Google Scholar 

  53. Neurotherm NT1100 Operator Guide. 2008 Wilmington, MA Neurotherm Inc

    Google Scholar 

  54. Gilligan J, Shih JC, Cai VL, Hirsch JA, Rodrigues C, Irani ZD (2016) Novel single puncture approach for simplicity 3 sacral plexus radiofrequency ablation: technical note. Pain Physician 19(4):E643–E648

    PubMed  Google Scholar 

  55. Hirsch JA, Barr JD, Zoarski GH (2013) Sacroplasty: beyond the beginning. J Neurointerv Surg 5(5):395

    Article  PubMed  Google Scholar 

  56. Gupta AC, Yoo AJ, Stone J, Barr JC, Brook A, Tutton S, Ortiz O, Hirsch AE, Larvie M, Frey ME, Jayaraman MV, Hirsch JA (2012) Percutaneous sacroplasty. J Neurointerv Surg 4(5):385–389

    Article  PubMed  Google Scholar 

  57. Frey ME, Depalma MJ, Cifu DX, Bhagia SM, Carne W, Daitch JS (2008) Percutaneous sacroplasty for osteoporotic sacral insufficiency fractures: a prospective, multicenter, observational pilot study. Spine J 8(2):367–373

    Article  PubMed  Google Scholar 

  58. Gupta AC, Chandra RV, Yoo AJ, Leslie-Mazwi TM, Bell DL, Mehta BP, Vanderboom TL, Rabinov JD, Larvie M, Hirsch JA (2014) Safety and effectiveness of sacroplasty: a large single-center experience. AJNR Am J Neuroradiol 35(11):2202–2206

    Article  CAS  PubMed  Google Scholar 

  59. Kortman K, Ortiz O, Miller T, Brook A, Tutton S, Mathis J, Georgy B (2013) Multicenter study to assess the efficacy and safety of sacroplasty in patients with osteoporotic sacral insufficiency fractures or pathologic sacral lesions. J Neurointerv Surg 5(5):461–466

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Brigham and Women’s Hospital, 75 Francis Street, Boston, MA, 02115, USA

    Christopher Gilligan MD

  2. Beth Israel Deaconess Medical Center, Harvard Medical School, 118 Riverway St, Apt 7, Boston, MA, 02215, USA

    Obaid S. Malik MD

  3. Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, USA

    Joshua A. Hirsch MD, FACR, FSIR

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  1. Christopher Gilligan MD
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  2. Obaid S. Malik MD
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  3. Joshua A. Hirsch MD, FACR, FSIR
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Corresponding author

Correspondence to Joshua A. Hirsch MD, FACR, FSIR .

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Editors and Affiliations

  1. Radiology, Santissima Trinita Hospital Radiology, Cagliari, Italy

    Stefano Marcia

  2. Department of Radiology, University of Cagliari Department of Radiology, Cagliari, Italy

    Luca Saba

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Gilligan, C., Malik, O.S., Hirsch, J.A. (2017). Radiofrequency Ablation for Sacroiliac Joint Pain. In: Marcia, S., Saba, L. (eds) Radiofrequency Treatments on the Spine. Springer, Cham. https://doi.org/10.1007/978-3-319-41462-1_8

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  • DOI: https://doi.org/10.1007/978-3-319-41462-1_8

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