CT/X-Ray-Guided Thermal Ablation in Spinal Facets and Sacroiliac Joint Syndrome Disease

  • Stefano Marcia
  • Luca Saba
  • Federico D’Orazio
  • Massimo Gallucci
Chapter
Part of the New Procedures in Spinal Interventional Neuroradiology book series (NPSIN)

Abstract

Low back pain has a high lifetime incidence, coming to affect between 80 and 90 % of the general population during their lifetime. For decades, the focus of diagnosis and treatment of low back pain has been the intervertebral disc. However, the only presence of degenerative disc disease identified by imaging, with resultant surgical intervention, is not always rewarding, and nowadays it is well demonstrated that the rich innervation of the articular structures of the facet joints is often the cause of chronic back pain. Several treatments for pain of lumbar facet joints have been proposed, and these are mainly intra-articular steroid injections and radiofrequency denervation of the medial branches, which innervate the zygapophysial joint.

Another cause of low back pain can be attributed to painful sacroiliac dysfunction in up to 47 % of cases. The innervation of sacroiliac joint has a high degree of heterogeneity in the population, with many anatomical variants, many of which are still debated by the scientific community. Also for this joint it is possible to use different therapeutical approaches with fair evidence for cooled radiofrequency neurotomy and limited evidence for pulsed and conventional heat radiofrequency neurotomy.

Supplementary material

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Video 6.1 (AVI 307840 kb)

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Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Stefano Marcia
    • 1
  • Luca Saba
    • 2
  • Federico D’Orazio
    • 3
  • Massimo Gallucci
    • 3
  1. 1.Department of RadiologySS. Trinità Hospital ASL 8 CagliariCagliariItaly
  2. 2.Department of RadiologyAzienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo di MonserratoCagliariItaly
  3. 3.Neuroradiology UnitSan Salvatore HospitalL’AquilaItaly

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